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Organization
JLEGEND HEALTH CARE CENTER, LLC
Active
Organization
JLEGEND HEALTH CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SABUR OLAJIDE SHOWUNMI (CEO)
(713) 548-7073
Entity
Organization
Contact information
Practice address
9903 S DAIRY ASHFORD RD APT 4102, HOUSTON, TX 77099-2330
(713) 548-7073
Mailing address
9903 S DAIRY ASHFORD RD APT 4102, HOUSTON, TX 77099-2330
(713) 548-7073
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
10/07/2017
Last updated
10/07/2017
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