=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851429724
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAJESTIK CARE PROVIDERS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2007
-----------------------------------------------------
Last Update Date | 03/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8700 COMMERCE PARK DR STE 110
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-7423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-767-1729
-----------------------------------------------------
Fax | 832-767-2845
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8700 COMMERCE PARK DR STE 110
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77036-7423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-767-1729
-----------------------------------------------------
Fax | 832-767-2845
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF NURSING
-----------------------------------------------------
Name | MS. GERTRUDE O OKAFOR
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 281-685-0838
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 677907
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------