Healthcare Provider Details

I. General information

NPI: 1447675616
Provider Name (Legal Business Name): RITA N OBODOECHINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10503 ROCKLEY RD SUITE100
HOUSTON TX
77099-3553
US

IV. Provider business mailing address

10503 ROCKLEY RD SUITE100
HOUSTON TX
77099-3553
US

V. Phone/Fax

Practice location:
  • Phone: 281-498-1554
  • Fax: 281-498-1554
Mailing address:
  • Phone: 281-498-1554
  • Fax: 281-498-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1457855355
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: