MEDICARE: CENTURY CARE SERVICES

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	32056176251

General Provider Information

NPI Number	:	1821488974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTURY CARE SERVICES

Provider Business Mailing Address
First Line	:	12911 HANSEL LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12911 HANSEL LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4720
Country	:	US
Telephone Number	:	713-598-5806
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. IRINA PUKHOVICH
Credential	:
Telephone Number	:	713-598-5806

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	01/28/2015

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Directions to “CENTURY CARE SERVICES ” Practice Location

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