Healthcare Provider Details

I. General information

NPI: 1659298966
Provider Name (Legal Business Name): REPOSE RESIDENTIAL LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13814 CITRUS WOOD PARK LN
ROSHARON TX
77583-1640
US

IV. Provider business mailing address

13814 CITRUS WOOD PARK LN
ROSHARON TX
77583-1640
US

V. Phone/Fax

Practice location:
  • Phone: 832-419-3028
  • Fax:
Mailing address:
  • Phone: 832-419-3028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: TONI DIXON JONES
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 832-419-3028