MEDICARE: TRANSFORMING HANDS 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1235783986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSFORMING HANDS LLC

Provider Business Mailing Address
First Line	:	1622 CALEDONIA TRL
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5763
Country	:	US
Telephone Number	:	713-253-6836
Fax Number	:

Provider Business Practice Location Address
First Line	:	1622 CALEDONIA TRL
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5763
Country	:	US
Telephone Number	:	713-253-6836
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TAIWO MOPELOLA ABORISADE
Credential	:	RN
Telephone Number	:	713-253-6836

Provider Enumeration Date	:	07/31/2019
Last Update Date	:	07/31/2019

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