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Organization

JLEGEND HEALTH CARE CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SABUR OLAJIDE SHOWUNMI (CEO)
(713) 548-7073
Entity
Organization

Contact information

Practice address
9903 S DAIRY ASHFORD RD APT 4102, HOUSTON, TX 77099-2330
(713) 548-7073
Mailing address
9903 S DAIRY ASHFORD RD APT 4102, HOUSTON, TX 77099-2330
(713) 548-7073

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
10/07/2017
Last updated
10/07/2017
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