Provider Demographics
NPI:1033695283
Name:AXCESS HEALTHCARE LLC
Entity Type:Organization
Organization Name:AXCESS HEALTHCARE LLC
Other - Org Name:AXCESS HEALTHCARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ISIGUZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-440-9979
Mailing Address - Street 1:8303 SOUTHWEST FWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1650
Mailing Address - Country:US
Mailing Address - Phone:713-440-9979
Mailing Address - Fax:713-493-7222
Practice Address - Street 1:8303 SOUTHWEST FWY STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1650
Practice Address - Country:US
Practice Address - Phone:713-440-9979
Practice Address - Fax:713-493-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX394771501Medicaid