Healthcare Provider Details

I. General information

NPI: 1629303862
Provider Name (Legal Business Name): EXQUISITE HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19546 OTTER TRAIL COURT
KATY TX
77449
US

IV. Provider business mailing address

19546 OTTER TRAIL CT
KATY TX
77449-4552
US

V. Phone/Fax

Practice location:
  • Phone: 713-870-4208
  • Fax: 281-550-2294
Mailing address:
  • Phone: 713-870-4208
  • Fax: 281-550-2294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number012562
License Number StateTX

VIII. Authorized Official

Name: MRS. STELLA OBIAGELI NEBO
Title or Position: ADMINISTRATOR/DON
Credential: RN
Phone: 713-870-4208