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General NPI Number Information
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NPI Number | 1174027312
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Entity Type | Organization
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Legal Business Name | JADE COMMUNITY CARE, INC.
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 6115 WILL POINT LN
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City | RICHMOND
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State | TX
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Zip | 77469-6148
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Country | US
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Telephone | 713-447-0726
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Fax | 281-344-9309
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Provider Business Mailing Address
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Address Line | 6115 WILL POINT LN
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City | RICHMOND
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State | TX
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Zip | 77469-6148
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Country | US
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Telephone | 713-447-0726
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Fax | 281-344-9309
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Authorized Official
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Title or Position | CEO
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Name | JAMES ETTA JOHNSON-WILLIAMS
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Credential |
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Telephone | 713-447-0726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | TX
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