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NPI 1780781716

NPI 1780781716 : RAPHA NURSING & REHABILITATION CLINIC, INC : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1780781716
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    Entity Type          |    Organization 
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    Legal Business Name  |    RAPHA NURSING & REHABILITATION CLINIC, INC 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    05/11/2011
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Provider Practice Location Address
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    Address Line         |    11000 FONDREN RD C-5
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77096-5513
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    Country              |    US
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    Telephone            |    713-776-2500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11000 FONDREN RD C-5
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77096-5513
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    Country              |    US
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    Telephone            |    713-776-2500
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     SAMUEL FUNSHO FADIPE 
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    Credential           |    
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    Telephone            |    713-776-2500
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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       |    008552
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    License Number State |    TX
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