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General NPI Number Information
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NPI Number | 1679683544
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Entity Type | Organization
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Legal Business Name | ST JUDE VISITING NURSES HOME HEALTH, INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 6521 REMLAP ST
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City | HOUSTON
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State | TX
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Zip | 77055-5311
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Country | US
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Telephone | 713-783-5833
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Fax | 713-862-6833
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Provider Business Mailing Address
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Address Line | 6521 REMLAP ST
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City | HOUSTON
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State | TX
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Zip | 77055-5311
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Country | US
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Telephone | 713-783-5833
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Fax | 713-862-6833
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ERIC CHRISTIAN MORA
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Credential |
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Telephone | 713-783-5833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010872
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License Number State | TX
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