Provider Demographics
NPI:1265840359
Name:TRUITT SENIOR CARE CENTER AND HOMES
Entity Type:Organization
Organization Name:TRUITT SENIOR CARE CENTER AND HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-766-8274
Mailing Address - Street 1:1307 WILBURFORCE STREET
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091
Mailing Address - Country:US
Mailing Address - Phone:281-766-8274
Mailing Address - Fax:
Practice Address - Street 1:1307 WILBURFORCE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-2073
Practice Address - Country:US
Practice Address - Phone:281-766-8274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care