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General NPI Number Information
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NPI Number | 1841174208
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Entity Type | Organization
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Legal Business Name | PKLV
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2619 ARBOR ST
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City | HOUSTON
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State | TX
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Zip | 77004-6137
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Country | US
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Telephone | 469-657-2992
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Fax |
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Provider Business Mailing Address
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Address Line | 2619 ARBOR ST
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City | HOUSTON
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State | TX
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Zip | 77004-6137
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Country | US
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Telephone | 469-657-2992
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Fax |
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Authorized Official
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Title or Position | RN
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Name | PETER ODHIAMBO OKUMU
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Credential |
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Telephone | 469-657-2992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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