Healthcare Provider Details

I. General information

NPI: 1972373454
Provider Name (Legal Business Name): FRIENDSHIP ADULT DAYCENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12917 WEST BELLFORT AVE
SUGAR LAND TX
77478-1838
US

IV. Provider business mailing address

12917 WEST BELLFORT AVE
SUGAR LAND TX
77478-1838
US

V. Phone/Fax

Practice location:
  • Phone: 346-907-5977
  • Fax: 346-907-5839
Mailing address:
  • Phone: 346-907-5977
  • Fax: 346-907-5839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY ATOHAMEN ATIVIE
Title or Position: CEO
Credential:
Phone: 713-817-5774