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General NPI Number Information
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NPI Number | 1215665500
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Entity Type | Organization
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Legal Business Name | UNDER ELONDA' S CARE LLC
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 13839 PURPLEMARTIN ST
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City | HOUSTON
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State | TX
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Zip | 77083-6867
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Country | US
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Telephone | 183-295-5312
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Fax |
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Provider Business Mailing Address
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Address Line | 7211 SAN LUCAS DR
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City | HOUSTON
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State | TX
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Zip | 77083-2718
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Country | US
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Telephone | 832-955-3125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS ELONDA MAMBAKASA
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Credential | C.N.A
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Telephone | 832-955-3125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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