Provider Demographics
NPI:1356659940
Name:IDA'S HOUSE
Entity Type:Organization
Organization Name:IDA'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTO
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:DEONE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-505-5210
Mailing Address - Street 1:12265 FONDREN RD
Mailing Address - Street 2:1501
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4066
Mailing Address - Country:US
Mailing Address - Phone:713-505-5210
Mailing Address - Fax:
Practice Address - Street 1:12265 FONDREN RD
Practice Address - Street 2:1501
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4066
Practice Address - Country:US
Practice Address - Phone:713-505-5210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care