Provider Demographics
NPI:1407285299
Name:RAVEN HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:RAVEN HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:DAUNE
Authorized Official - Last Name:EASTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-480-4235
Mailing Address - Street 1:1560 W BAY AREA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2667
Mailing Address - Country:US
Mailing Address - Phone:281-480-4235
Mailing Address - Fax:281-480-4465
Practice Address - Street 1:1560 W BAY AREA BLVD STE 302
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2667
Practice Address - Country:US
Practice Address - Phone:281-480-4235
Practice Address - Fax:281-480-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care