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General NPI Number Information
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NPI Number | 1992149629
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Entity Type | Organization
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Legal Business Name | WILBURN HEALTHCARE MANAGEMENT SERVICES
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 737 HIGHWAY 6 FM 520
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City | HOUSTON
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State | TX
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Zip | 77084
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Country | US
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Telephone | 800-265-6089
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 91288
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City | HOUSTON
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State | TX
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Zip | 77291-1288
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Country | US
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Telephone | 800-265-6089
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JAY HACKADAY
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Credential |
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Telephone | 800-265-6089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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