Provider Demographics
NPI:1407319015
Name:SIBIU LLC
Entity Type:Organization
Organization Name:SIBIU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIU
Authorized Official - Middle Name:
Authorized Official - Last Name:RADUTIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-804-2745
Mailing Address - Street 1:24181 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-5649
Mailing Address - Country:US
Mailing Address - Phone:281-804-2745
Mailing Address - Fax:
Practice Address - Street 1:24181 KELLY ST
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-5649
Practice Address - Country:US
Practice Address - Phone:281-804-2745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home