Provider Demographics
NPI:1376542662
Name:CONSOLIDATED COMMUNITY RESOURCES INC
Entity Type:Organization
Organization Name:CONSOLIDATED COMMUNITY RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:E
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:NWANNA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-596-9030
Mailing Address - Street 1:1314 COLONY LAKES DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4007
Mailing Address - Country:US
Mailing Address - Phone:713-596-9030
Mailing Address - Fax:713-596-9031
Practice Address - Street 1:6200 SAVOY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3320
Practice Address - Country:US
Practice Address - Phone:713-596-9030
Practice Address - Fax:713-596-9031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX458333251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458333Medicare ID - Type UnspecifiedAGENCY MEDICARE NUMBER