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General NPI Number Information
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NPI Number | 1679346654
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Entity Type | Organization
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Legal Business Name | AMAZED CARE GROUP LLC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 2702 RAINFLOWER MEADOW LN
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City | KATY
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State | TX
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Zip | 77494-7814
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Country | US
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Telephone | 602-489-8616
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Fax |
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Provider Business Mailing Address
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Address Line | 2702 RAINFLOWER MEADOW LN
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City | KATY
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State | TX
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Zip | 77494-7814
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Country | US
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Telephone | 602-489-8616
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | HELEN DIKE
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Credential |
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Telephone | 602-489-8616
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 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 #4
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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