Organization
MAPLE RIDGE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAEZE KELECHI FREGENE (PROGRAM MANAGER)
(832) 628-7570
Entity
Organization
Contact information
Practice address
29712 FULSHEAR LAKE TRCE, RICHMOND, TX 77406-3316
(832) 628-7570
Mailing address
29712 FULSHEAR LAKE TRCE, RICHMOND, TX 77406-3316
(832) 628-7570
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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