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General NPI Number Information
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NPI Number | 1295259810
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Entity Type | Organization
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Legal Business Name | RUTH RESIDENTIAL SERVICES
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 20606 S BLUE HYACINTH DR
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City | CYPRESS
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State | TX
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Zip | 77433-6698
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Country | US
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Telephone | 832-762-8451
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Fax |
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Provider Business Mailing Address
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Address Line | 20606 S BLUE HYACINTH DR
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City | CYPRESS
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State | TX
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Zip | 77433-6698
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Country | US
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Telephone | 832-762-8451
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | DAWIT KIDANE
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Credential | RN
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Telephone | 832-762-8451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 824816
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License Number State | TX
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