Provider Demographics
NPI:1083850705
Name:MOYO RAFIKI HOME AND COMMUNITY BASED SERVIC INC
Entity Type:Organization
Organization Name:MOYO RAFIKI HOME AND COMMUNITY BASED SERVIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-818-4091
Mailing Address - Street 1:1410 COOL SPRING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-3636
Mailing Address - Country:US
Mailing Address - Phone:832-818-4091
Mailing Address - Fax:
Practice Address - Street 1:1410 COOL SPRING DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-3636
Practice Address - Country:US
Practice Address - Phone:832-818-4091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care