Provider Demographics
NPI:1407629009
Name:EMPRESS GOLD INTERNATIONAL LLC
Entity Type:Organization
Organization Name:EMPRESS GOLD INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIMBIAT
Authorized Official - Middle Name:TEMILOLA
Authorized Official - Last Name:OLOWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-435-2430
Mailing Address - Street 1:735 CRYSTAL LAKES DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-4517
Mailing Address - Country:US
Mailing Address - Phone:504-435-2430
Mailing Address - Fax:
Practice Address - Street 1:735 CRYSTAL LAKES DR
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-4517
Practice Address - Country:US
Practice Address - Phone:504-435-2430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty