Healthcare Provider Details

I. General information

NPI: 1457596736
Provider Name (Legal Business Name): CHUNGO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10203 GOLDENVIEW PARK LN
SUGAR LAND TX
77498-2185
US

IV. Provider business mailing address

10203 GOLDENVIEW PARK LN
SUGAR LAND TX
77498-2185
US

V. Phone/Fax

Practice location:
  • Phone: 713-771-7333
  • Fax: 713-771-3113
Mailing address:
  • Phone: 713-771-7333
  • Fax: 713-771-3113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ABIGAIL N OKEADU
Title or Position: CEO
Credential:
Phone: 713-771-7333