MEDICARE: RELIEF CARE GROUP 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	163WP2201X	Ambulatory Care Registered Nurse

General Provider Information

NPI Number	:	1578153763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIEF CARE GROUP LLC

Provider Business Mailing Address
First Line	:	5340 WESLAYAN ST # 273407
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	414 N SAM HOUSTON PKWY E STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3508
Country	:	US
Telephone Number	:	281-968-5906
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEILAN PETERSON
Credential	:
Telephone Number	:	713-352-9439

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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