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Organization
PERISSEUO GROUP LLC
Active
Organization
PERISSEUO GROUP LLC
Active
Other names
Coastland Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILMA JEANNETTE HARDESTY PT DPT (CEO)
(281) 943-9997
Entity
Organization
Contact information
Practice address
135 OYSTER CREEK DR STE P, LAKE JACKSON, TX 77566-4118
(979) 480-1093
(979) 429-4020
Mailing address
135 OYSTER CREEK DR STE P, LAKE JACKSON, TX 77566-4118
(979) 480-1093
(979) 429-4020
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4101131-01
—
TX
Enumeration date
08/23/2021
Last updated
08/23/2021
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