Provider Demographics
NPI:1508054644
Name:NISSI RESIDENTIAL CARE HOME, INC.
Entity Type:Organization
Organization Name:NISSI RESIDENTIAL CARE HOME, INC.
Other - Org Name:TEXMAX
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIOGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-661-8306
Mailing Address - Street 1:11107 STROUD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3017
Mailing Address - Country:US
Mailing Address - Phone:832-661-8306
Mailing Address - Fax:281-561-9341
Practice Address - Street 1:11107 STROUD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3017
Practice Address - Country:US
Practice Address - Phone:281-808-9563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility