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General NPI Number Information
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NPI Number | 1629626403
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Entity Type | Organization
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Legal Business Name | GRAFFITI HOME CARE L.L.C.
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 11201 VETERANS MEMORIAL DR APT 13206
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City | HOUSTON
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State | TX
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Zip | 77067-3861
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Country | US
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Telephone | 228-265-0331
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 VETERANS MEMORIAL DR APT 13206
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City | HOUSTON
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State | TX
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Zip | 77067-3861
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Country | US
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Telephone | 228-265-0331
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. TYTEILA MORDRIA ROACH
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Credential |
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Telephone | 228-265-0331
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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