MEDICARE: ENDECA INVESTMENTS, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1619426186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDECA INVESTMENTS, LLC

Provider Business Mailing Address
First Line	:	118 VINTAGE PARK BLVD
Second Line	:	SUITE W
City	:	HOUSTON
State	:	TX
Zip	:	77070-4095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 VINTAGE PARK BLVD
Second Line	:	SUITE W
City	:	HOUSTON
State	:	TX
Zip	:	77070-4095
Country	:	US
Telephone Number	:	832-680-0111
Fax Number	:	832-680-0113

Authorized Official
Title or Position	:	CEO
Name	:	MRS. TAMARA CLAUNCH
Credential	:
Telephone Number	:	832-680-0111

Provider Enumeration Date	:	09/26/2016
Last Update Date	:	09/26/2016

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