Provider Demographics
NPI:1073994786
Name:ALLISON CARE HOME
Entity Type:Organization
Organization Name:ALLISON CARE HOME
Other - Org Name:GOD BE WILLING HOME HEALTH LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:JERMAINE
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-6267
Mailing Address - Street 1:3880 GREENHOUSE RD STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3487
Mailing Address - Country:US
Mailing Address - Phone:281-463-6267
Mailing Address - Fax:281-463-6297
Practice Address - Street 1:3880 GREENHOUSE RD STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3487
Practice Address - Country:US
Practice Address - Phone:281-463-6267
Practice Address - Fax:281-463-6297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities