Healthcare Provider Details

I. General information

NPI: 1144741869
Provider Name (Legal Business Name): EMERALD TOTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 SOUTHWEST FWY STE 370
HOUSTON TX
77074-1140
US

IV. Provider business mailing address

10101 SOUTHWEST FWY STE 370
HOUSTON TX
77074-1140
US

V. Phone/Fax

Practice location:
  • Phone: 866-832-0522
  • Fax: 281-973-4606
Mailing address:
  • Phone: 866-832-0522
  • Fax: 281-973-4606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: RONKE ODIGIE
Title or Position: DIRECTOR
Credential:
Phone: 866-832-0522