Organization
FADERAH LOGISTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIUS OBINWUGO (C.E.O.)
(713) 355-7614
Entity
Organization
Contact information
Practice address
21226 BARTON HOLLOW LN, RICHMOND, TX 77407-6418
(713) 355-7614
Mailing address
21226 BARTON HOLLOW LN, RICHMOND, TX 77407-6418
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/26/2018
Last updated
10/23/2020
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