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General NPI Number Information
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NPI Number | 1881974871
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Entity Type | Organization
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Legal Business Name | IMMACULATE HOME CARE
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 9102 KNIGHTSLAND TRL
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City | HOUSTON
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State | TX
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Zip | 77083-6580
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Country | US
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Telephone | 832-290-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 9102 KNIGHTSLAND TRL
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City | HOUSTON
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State | TX
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Zip | 77083-6580
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Country | US
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Telephone | 832-290-2544
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. FOLUSO AKEYE
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Credential |
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Telephone | 832-290-2544
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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 |
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License Number State |
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