MEDICARE: MODEAS PERSONAL CARE HOME INC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1184054272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODEAS PERSONAL CARE HOME INC

Provider Business Mailing Address
First Line	:	8833 TALTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77078-3826
Country	:	US
Telephone Number	:	832-891-7075
Fax Number	:

Provider Business Practice Location Address
First Line	:	8833 TALTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77078-3826
Country	:	US
Telephone Number	:	832-891-7075
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. FEFI JAMES
Credential	:
Telephone Number	:	832-891-7075

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	11/26/2013

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Directions to “MODEAS PERSONAL CARE HOME INC ” Practice Location

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