Organization
FRESH OUTPOURING OUTREACH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED OMORUYI (DIRECTOR)
(832) 775-8463
Entity
Organization
Contact information
Practice address
186 SANDPEBBLE DR, THE WOODLANDS, TX 77381-3225
(832) 775-8463
Mailing address
186 SANDPEBBLE DR, THE WOODLANDS, TX 77381-3225
(832) 775-8463
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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