Organization
MIMSHACK CARE HOMES LLC
Active
Organization
MIMSHACK CARE HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHINYERE AGBAFOR (C.E.O/PROGRAM MANAGER)
(832) 277-2618
Entity
Organization
Contact information
Practice address
12330 SPRINGCREST DR, HOUSTON, TX 77072-3219
(832) 277-2618
Mailing address
12330 SPRINGCREST DR, HOUSTON, TX 77072-3219
(832) 277-2618
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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