MEDICARE: IROKO ENTERPRISES, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1558594143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IROKO ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	12329 FONDREN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-5201
Country	:	US
Telephone Number	:	713-726-9668
Fax Number	:	713-729-3585

Provider Business Practice Location Address
First Line	:	12329 FONDREN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-5201
Country	:	US
Telephone Number	:	713-726-9668
Fax Number	:	713-729-3585

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ADE KUJIMIYO
Credential	:
Telephone Number	:	713-726-9668

Provider Enumeration Date	:	08/28/2009
Last Update Date	:	08/28/2009

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Directions to “IROKO ENTERPRISES, INC. ” Practice Location

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