MEDICARE: SECURE DAY ACTIVITY AND HEALTH CARE FACILITIES, 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	251C00000X	Developmentally Disabled Services Day Training Agency	119214	TX

General Provider Information

NPI Number	:	1386869840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECURE DAY ACTIVITY AND HEALTH CARE FACILITIES, INC

Provider Business Mailing Address
First Line	:	3008 BLODGETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5304
Country	:	US
Telephone Number	:	713-807-1999
Fax Number	:	713-807-7175

Provider Business Practice Location Address
First Line	:	3008 BLODGETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5304
Country	:	US
Telephone Number	:	713-807-1999
Fax Number	:	713-807-7175

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. SHAMRA S HODGE
Credential	:
Telephone Number	:	713-807-1999

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

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