Organization
THE DOMENECH GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALEXIS DOMENECH CNA (MANAGER)
(409) 692-5783
Entity
Organization
Contact information
Practice address
8226 BROADLEAF AVE, BAYTOWN, TX 77521-5556
(409) 692-5783
Mailing address
8226 BROADLEAF AVE, BAYTOWN, TX 77521-5556
(409) 692-5783
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251T00000X
PACE Provider Organization
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225702517
CNA
—
Enumeration date
10/21/2021
Last updated
02/08/2022
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