Organization
VINTAGE HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYQUEEN O CHILAKA PHARMD (PRESIDENT)
(832) 439-4117
Entity
Organization
Contact information
Practice address
2302 WINDCROFT LN, SUGAR LAND, TX 77479-2383
(832) 439-4117
Mailing address
2302 WINDCROFT LN, SUGAR LAND, TX 77479-2383
(832) 439-4117
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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