Healthcare Provider Details

I. General information

NPI: 1780140970
Provider Name (Legal Business Name): ACCESS CARE LIVING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 06/08/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12435 GIRASOLE CT
RICHMOND TX
77406-2097
US

IV. Provider business mailing address

3418 STATE HWY 6 SOUTH, STE B #349
HOUSTON TX
77082-2097
US

V. Phone/Fax

Practice location:
  • Phone: 281-935-9365
  • Fax:
Mailing address:
  • Phone: 281-935-9365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ESTHER O ANYAORAH
Title or Position: PROGRAM MANGER
Credential:
Phone: 281-935-9365