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Organization

A1 NOSTALGIC CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LILIAN T OBAYEMI (DIRECTOR)
(832) 418-8269
Entity
Organization

Contact information

Practice address
10426 LYRA GLEN LN, RICHMOND, TX 77406-3271
(832) 418-8269
Mailing address
10426 LYRA GLEN LN, RICHMOND, TX 77406-3271
(832) 418-8269

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
376G00000X
Nursing Home Administrator

Other

Enumeration date
03/15/2024
Last updated
04/09/2024
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