Organization
IMMACULATE NURSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAFAYAT MOGOLI (MANAGER)
(832) 497-9982
Entity
Organization
Contact information
Practice address
3125 BOULDER RANCH DR, HOUSTON, TX 77063-1482
(832) 517-5572
Mailing address
3125 BOULDER RANCH DR, HOUSTON, TX 77063-1482
(832) 517-5572
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
12/23/2025
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