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General NPI Number Information
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NPI Number | 1407285299
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Entity Type | Organization
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Legal Business Name | RAVEN HEALTHCARE SERVICES INC.
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/02/2013
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Provider Practice Location Address
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Address Line | 1560 W BAY AREA BLVD STE 302
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2667
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Country | US
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Telephone | 281-480-4235
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Fax | 281-480-4465
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Provider Business Mailing Address
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Address Line | 1560 W BAY AREA BLVD STE 302
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-2667
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Country | US
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Telephone | 281-480-4235
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Fax | 281-480-4465
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. STEPHANIE DAUNE EASTWOOD
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Credential |
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Telephone | 281-480-4235
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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