Organization
PEPPERTREE COMPLETE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINA JEFFERSON (CEO)
(832) 527-6750
Entity
Organization
Contact information
Practice address
11818 LONGWOOD GARDEN WAY, HOUSTON, TX 77047-4434
(832) 900-2384
Mailing address
2600 S LOOP W STE 448, HOUSTON, TX 77054-2606
(832) 900-2384
(888) 259-5108
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1016629
TX
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001008749
TX HHSC LONGTERM CARE CONTRACT NUMBER
TX
Enumeration date
10/30/2008
Last updated
12/11/2023
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