Provider Demographics
NPI:1407454176
Name:VIANDSA CARE HOME LLC
Entity Type:Organization
Organization Name:VIANDSA CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EROMOSELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-885-6050
Mailing Address - Street 1:17203 QUIET SONG CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2964
Mailing Address - Country:US
Mailing Address - Phone:713-885-6050
Mailing Address - Fax:
Practice Address - Street 1:17203 QUIET SONG CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2964
Practice Address - Country:US
Practice Address - Phone:713-885-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities