Organization
LAKECREST CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLAJUMOKE OLAYEMI (OWNER)
(973) 454-1952
Entity
Organization
Contact information
Practice address
24523 FOREST CANOPY DR, KATY, TX 77493-1886
(973) 454-1952
Mailing address
24523 FOREST CANOPY DR, KATY, TX 77493-1886
(973) 454-1952
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
09/11/2018
Last updated
10/29/2018
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