Provider Demographics
NPI:1467760637
Name:J. P. IMMACULATE HEALTHCARE INC
Entity Type:Organization
Organization Name:J. P. IMMACULATE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-495-5721
Mailing Address - Street 1:2506 SUMMER HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2177
Mailing Address - Country:US
Mailing Address - Phone:832-495-5721
Mailing Address - Fax:832-495-5721
Practice Address - Street 1:2506 SUMMER HAVEN LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2177
Practice Address - Country:US
Practice Address - Phone:832-495-5721
Practice Address - Fax:832-495-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health