Provider Demographics
NPI:1073809653
Name:AGILITY ADULT DAY CARE & ACTIVITIES
Entity Type:Organization
Organization Name:AGILITY ADULT DAY CARE & ACTIVITIES
Other - Org Name:AGILITY ADULT DAY CARE & ACTIVITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:832-969-3339
Mailing Address - Street 1:9335 HUDSON BEND CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2251
Mailing Address - Country:US
Mailing Address - Phone:832-969-3339
Mailing Address - Fax:
Practice Address - Street 1:9335 HUDSON BEND CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2251
Practice Address - Country:US
Practice Address - Phone:832-969-3339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care