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General NPI Number Information
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NPI Number | 1659625614
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Entity Type | Organization
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Legal Business Name | AQTDM HOMES
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 9118 MESA DR
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City | HOUSTON
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State | TX
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Zip | 77028-1605
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Country | US
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Telephone | 713-633-2827
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Fax | 832-360-2768
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Provider Business Mailing Address
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Address Line | 9118 MESA DR
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City | HOUSTON
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State | TX
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Zip | 77028-1605
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Country | US
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Telephone | 713-633-2827
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Fax | 832-360-2768
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Authorized Official
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Title or Position | OWNER
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Name | DEAUNSEY ALEXANDER
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Credential |
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Telephone | 713-633-2827
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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 | TX
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