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General NPI Number Information
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NPI Number | 1558594382
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Entity Type | Organization
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Legal Business Name | OBOSA HEALTH CARE SERVICES
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 16703 LAZY RIDGE RD
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City | HOUSTON
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State | TX
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Zip | 77053-4663
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Country | US
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Telephone | 713-429-1873
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Fax |
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Provider Business Mailing Address
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Address Line | 16703 LAZY RIDGE RD
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City | HOUSTON
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State | TX
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Zip | 77053-4663
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Country | US
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Telephone | 713-429-1873
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER OBASOGIE
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Credential |
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Telephone | 281-690-1941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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