Healthcare Provider Details

I. General information

NPI: 1972952893
Provider Name (Legal Business Name): HOUSE OF FAITH HCS CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7319 KYLE TRAIL CT
RICHMOND TX
77407-8035
US

IV. Provider business mailing address

7319 KYLE TRAIL CT
RICHMOND TX
77407-8035
US

V. Phone/Fax

Practice location:
  • Phone: 713-296-0190
  • Fax: 832-917-5211
Mailing address:
  • Phone: 713-296-0196
  • Fax: 832-917-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: OSAMUYIMEN DAVID AGHIMIEN
Title or Position: DIRECTOR
Credential:
Phone: 713-296-0190