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General NPI Number Information
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NPI Number | 1568699874
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Entity Type | Organization
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Legal Business Name | AGING CARE MANAGEMENT COMPANY
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 13811 BENTPATH DR
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City | HOUSTON
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State | TX
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Zip | 77014-2880
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Country | US
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Telephone | 832-891-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 13811 BENTPATH DR
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City | HOUSTON
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State | TX
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Zip | 77014-2880
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Country | US
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Telephone | 832-891-4379
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROSE B MADISON
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Credential | BA.,MA., LNFA
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Telephone | 832-891-4379
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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 | 9049
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 9049
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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