Healthcare Provider Details

I. General information

NPI: 1700591302
Provider Name (Legal Business Name): DELIS ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14103 WHITE OAK GARDENS DR
CYPRESS TX
77429-3938
US

IV. Provider business mailing address

14173 NORTHWEST FWY # 249
HOUSTON TX
77040-5013
US

V. Phone/Fax

Practice location:
  • Phone: 346-282-4422
  • Fax:
Mailing address:
  • Phone: 346-282-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DANA ELLIS
Title or Position: CEO
Credential:
Phone: 346-282-4422