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General NPI Number Information
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NPI Number | 1518364421
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Entity Type | Organization
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Legal Business Name | A PARADISE CARE RESOURCE LLC
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 6434 BRIAR MOSS LN
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City | KATY
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State | TX
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Zip | 77449-8550
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Country | US
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Telephone | 832-404-8708
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Fax |
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Provider Business Mailing Address
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Address Line | 6434 BRIAR MOSS LN
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City | KATY
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State | TX
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Zip | 77449-8550
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Country | US
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Telephone | 832-404-8708
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GENET TECLU
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Credential |
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Telephone | 832-404-8708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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