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General NPI Number Information
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NPI Number | 1194237016
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Entity Type | Organization
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Legal Business Name | ENVISION FOR LIFE HEALTHCARE INC
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 14461 STILL MEADOW DR
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City | HOUSTON
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State | TX
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Zip | 77079-3137
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Country | US
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Telephone | 832-931-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 14461 STILL MEADOW DR
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City | HOUSTON
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State | TX
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Zip | 77079-3137
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Country | US
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Telephone | 832-931-3376
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. VICTORIA OKON
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Credential |
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Telephone | 832-931-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 018102
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License Number State | TX
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