MEDICARE: RITA N OBODOECHINA

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	373H00000X	Day Training/Habilitation Specialist
2	261QA0600X	Adult Day Care Clinic/Center	1457855355	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447675616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA N OBODOECHINA

Provider Business Mailing Address
First Line	:	10503 ROCKLEY RD
Second Line	:	SUITE100
City	:	HOUSTON
State	:	TX
Zip	:	77099-3553
Country	:	US
Telephone Number	:	281-498-1554
Fax Number	:	281-498-1554

Provider Business Practice Location Address
First Line	:	10503 ROCKLEY RD
Second Line	:	SUITE100
City	:	HOUSTON
State	:	TX
Zip	:	77099-3553
Country	:	US
Telephone Number	:	281-498-1554
Fax Number	:	281-498-1554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2014
Last Update Date	:	03/30/2022

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Directions to “ RITA N OBODOECHINA ” Practice Location

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