Healthcare Provider Details

I. General information

NPI: 1689353021
Provider Name (Legal Business Name): AKA HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 GULF FWY
TEXAS CITY TX
77591-2819
US

IV. Provider business mailing address

PO BOX 233
RICHMOND TX
77406-0006
US

V. Phone/Fax

Practice location:
  • Phone: 409-935-0300
  • Fax: 409-908-0409
Mailing address:
  • Phone: 281-262-2054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BETH ALYSE FERGUSON
Title or Position: OWNER
Credential:
Phone: 713-281-2275