Healthcare Provider Details

I. General information

NPI: 1720132814
Provider Name (Legal Business Name): BJ LIVING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 BRAXTON DR
HOUSTON TX
77063-6303
US

IV. Provider business mailing address

3945 BRAXTON DR
HOUSTON TX
77063-6303
US

V. Phone/Fax

Practice location:
  • Phone: 713-784-1787
  • Fax: 713-784-4701
Mailing address:
  • Phone: 713-784-1787
  • Fax: 713-784-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. REBECCA OMO ELABOR
Title or Position: CEO
Credential: PROVIDER
Phone: 713-784-1787