Organization
AMAZING LIFE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRISTAN JOSEPH HOGAN (PROGRAM MANAGER/PART-OWNER)
(903) 917-1115
Entity
Organization
Contact information
Practice address
159 EVANSTON ST, HOUSTON, TX 77015-1613
(903) 917-1115
Mailing address
159 EVANSTON ST, HOUSTON, TX 77015-1613
(903) 917-1115
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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