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General NPI Number Information
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NPI Number | 1164449120
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Entity Type | Organization
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Legal Business Name | GRARUDA ENTERPRISES, INC.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 4000 DOVER ST STE 100
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City | HOUSTON
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State | TX
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Zip | 77087-4694
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Country | US
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Telephone | 713-944-0500
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Fax | 713-944-0600
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Provider Business Mailing Address
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Address Line | 4000 DOVER ST SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77087-4693
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Country | US
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Telephone | 713-944-0500
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Fax | 713-944-0600
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BENITA TURK
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Credential |
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Telephone | 713-944-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 007402
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License Number State | TX
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