MEDICARE: NCJ HEALTH SYSTEM 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
2	251E00000X	Home Health Agency	010085	TX

General Provider Information

NPI Number	:	1740469840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NCJ HEALTH SYSTEM INC

Provider Business Mailing Address
First Line	:	104 INDUSTRIAL BLVD STE D
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3170
Country	:	US
Telephone Number	:	713-772-4858
Fax Number	:	713-772-4857

Provider Business Practice Location Address
First Line	:	104 INDUSTRIAL BLVD STE D
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3170
Country	:	US
Telephone Number	:	713-772-4858
Fax Number	:	713-772-4857

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. UDOKA OKOLIE
Credential	:
Telephone Number	:	713-772-4858

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	08/22/2023

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