MEDICARE: GOOD CITIZEN HEALTH CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1497042550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD CITIZEN HEALTH CARE INC

Provider Business Mailing Address
First Line	:	7900 CREEKBEND DR
Second Line	:	#817
City	:	HOUSTON
State	:	TX
Zip	:	77071-1642
Country	:	US
Telephone Number	:	713-498-3142
Fax Number	:	281-575-9924

Provider Business Practice Location Address
First Line	:	7900 CREEKBEND DR
Second Line	:	#817
City	:	HOUSTON
State	:	TX
Zip	:	77071-1642
Country	:	US
Telephone Number	:	713-498-3142
Fax Number	:	281-575-9924

Authorized Official
Title or Position	:	CEO
Name	:	MR. MOSES RAPHAEL OKEKE
Credential	:
Telephone Number	:	713-498-3142

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	08/22/2013

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