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General NPI Number Information
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NPI Number | 1225349848
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Entity Type | Organization
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Legal Business Name | JOURNEYS OF EVOLUTION
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 6630 LAUGHLIN DR
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City | MISSOURI CITY
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State | TX
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Zip | 77489-3530
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Country | US
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Telephone | 713-449-4215
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Fax | 281-741-7689
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Provider Business Mailing Address
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Address Line | PO BOX 2244
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City | MISSOURI CITY
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State | TX
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Zip | 77459-9244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIKKI M LECOMPTE
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Credential |
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Telephone | 713-449-4215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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