Provider Demographics
NPI: | 1053622779 |
---|---|
Name: | ASSURANCEJ HOMECARE SERVICES ,INC. |
Entity type: | Organization |
Organization Name: | ASSURANCEJ HOMECARE SERVICES ,INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JUDITH |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | NWOKORIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-988-2618 |
Mailing Address - Street 1: | PO BOX 31626 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77231-1626 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-988-2618 |
Mailing Address - Fax: | 713-988-2619 |
Practice Address - Street 1: | 11602 BURDINE ST STE B |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77035-2704 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-988-2618 |
Practice Address - Fax: | 713-988-2619 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-06-28 |
Last Update Date: | 2024-09-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 182449201 | Medicaid | |
TX | 1053622779 | Medicaid |