Organization
SCULPT STATION BY Z LLC
Active
Other names
Impact 360 Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
EBONI ZANDRANETTE DAVIS (PROGRAM DIRECTOR)
(281) 241-9183
Entity
Organization
Contact information
Practice address
8625 WINKLER DR APT 1205, HOUSTON, TX 77017-5107
(281) 241-9183
Mailing address
2601 CARTWRIGHT RD # D233, MISSOURI CITY, TX 77459-2613
(281) 241-9183
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/16/2024
Last updated
12/19/2024
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