Organization
LAKAYES GRACIOUS HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMEKA KOTUN (OWNER)
(832) 986-2826
Entity
Organization
Contact information
Practice address
1807 TANGLEBERRY CT, FRESNO, TX 77545-7520
(832) 986-2826
Mailing address
PO BOX 1722, TEXAS CITY, TX 77592-1722
(832) 986-2826
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343800000X
Secured Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
08/07/2024
Last updated
08/14/2024
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