Organization
AYANNI'S SAFEHOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY RANDOLPH (CEO)
(281) 691-1605
Entity
Organization
Contact information
Practice address
13230 SEAGLER PARK LN, HOUSTON, TX 77047-4476
(281) 691-1605
Mailing address
13230 SEAGLER PARK LN, HOUSTON, TX 77047-4476
(281) 691-1605
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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