Healthcare Provider Details

I. General information

NPI: 1962760975
Provider Name (Legal Business Name): TOWER OF MERCY HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10333 HARWIN DR 535F
HOUSTON TX
77036-1545
US

IV. Provider business mailing address

10333 HARWIN DR 535F
HOUSTON TX
77036-1545
US

V. Phone/Fax

Practice location:
  • Phone: 713-370-1363
  • Fax:
Mailing address:
  • Phone: 713-370-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberLVN
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberLVN
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberLVN
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: MS. AGNES KEHINDE OJELADE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LVN
Phone: 713-370-1363