Healthcare Provider Details

I. General information

NPI: 1023765450
Provider Name (Legal Business Name): NOIR SUNFLOWERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2022
Last Update Date: 03/06/2022
Certification Date: 03/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 HOLMAN ST
HOUSTON TX
77004-4245
US

IV. Provider business mailing address

2413 HOLMAN ST
HOUSTON TX
77004-4245
US

V. Phone/Fax

Practice location:
  • Phone: 183-257-1584
  • Fax:
Mailing address:
  • Phone: 183-257-1584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEIARRA SANAE JONES
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 832-571-5843