MEDICARE: AGE IN PLACE HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134735707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGE IN PLACE HOMECARE LLC

Provider Business Mailing Address
First Line	:	9896 BISSONNET ST STE 460
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-8156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9896 BISSONNET ST STE 460
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-8156
Country	:	US
Telephone Number	:	832-728-7168
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ADESOJI OREBAJO
Credential	:
Telephone Number	:	832-728-7168

Provider Enumeration Date	:	09/19/2020
Last Update Date	:	09/19/2020

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