MEDICARE: AMEN RESOURCES

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1619277332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEN RESOURCES

Provider Business Mailing Address
First Line	:	2527 VILLAGE SQUARE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-4093
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2527 VILLAGE SQUARE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-4093
Country	:	US
Telephone Number	:	281-261-8696
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	OSAS M OKPAMEN
Credential	:
Telephone Number	:	281-261-8696

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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Directions to “AMEN RESOURCES ” Practice Location

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