MEDICARE: AZUSA GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
3	320700000X	Physical Disabilities Residential Treatment Facility
4	320800000X	Mental Illness Community Based Residential Treatment Facility
5	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
6	251B00000X	Case Management Agency
7	251E00000X	Home Health Agency
8	251G00000X	Community Based Hospice Care Agency
9	253J00000X	Foster Care Agency
10	253Z00000X	In Home Supportive Care Agency
11	310400000X	Assisted Living Facility
12	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831734870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZUSA GROUP LLC

Provider Business Mailing Address
First Line	:	8403 MISTY PRAIRIE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2480
Country	:	US
Telephone Number	:	832-375-9397
Fax Number	:

Provider Business Practice Location Address
First Line	:	8403 MISTY PRAIRIE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2480
Country	:	US
Telephone Number	:	832-375-9397
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. OLUFEMI OLAWALE OLUSESI
Credential	:	MD
Telephone Number	:	832-375-9397

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	09/02/2025

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Directions to “AZUSA GROUP LLC ” Practice Location

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