Organization
SAGE COMMUNITY PROVIDERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSAGIE OWEN ODEH (CEO)
(504) 258-4474
Entity
Organization
Contact information
Practice address
12807 ASHFORD MEADOW DR, HOUSTON, TX 77082-2136
(504) 258-4474
Mailing address
12807 ASHFORD MEADOW DR, HOUSTON, TX 77082-2136
(504) 258-4474
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
800613749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800613749
—
TX
Enumeration date
01/01/2011
Last updated
01/01/2011
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