Provider Demographics
NPI:1235297912
Name:AMUDEK
Entity Type:Organization
Organization Name:AMUDEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSEGUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEKUNLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-779-2847
Mailing Address - Street 1:9138 MARTIN HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2745
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:281-394-3760
Practice Address - Street 1:9138 MARTIN HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2745
Practice Address - Country:US
Practice Address - Phone:713-988-0465
Practice Address - Fax:281-394-3760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities