Healthcare Provider Details

I. General information

NPI: 1043617624
Provider Name (Legal Business Name): ENDLESS OPPORTUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11144 FUQUA STREET 1123
HOUSTON TX
77089-2650
US

IV. Provider business mailing address

11144 FUQUA STREET 1123
HOUSTON TX
77089-2650
US

V. Phone/Fax

Practice location:
  • Phone: 832-468-9311
  • Fax: 832-698-9531
Mailing address:
  • Phone: 832-468-9311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JOHNELL FERNANDEZ
Title or Position: CEO
Credential: LMSW MBA
Phone: 832-468-9311