Provider Demographics
NPI:1053979658
Name:WM SENIOR CARE LLC
Entity type:Organization
Organization Name:WM SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMEON
Authorized Official - Middle Name:DAMIAN
Authorized Official - Last Name:ANUGWOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-362-5696
Mailing Address - Street 1:11497 COON HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77306-7731
Mailing Address - Country:US
Mailing Address - Phone:800-803-5816
Mailing Address - Fax:936-231-1703
Practice Address - Street 1:11497 COON HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77306-7731
Practice Address - Country:US
Practice Address - Phone:800-803-5816
Practice Address - Fax:936-231-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility