Provider Demographics
NPI:1518302082
Name:ONE COURAGEOUS HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:ONE COURAGEOUS HEALTHCARE SERVICES, INC.
Other - Org Name:ONE CORAGEOUS - HOSPICE/PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:EC
Authorized Official - Last Name:UKAWILU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-649-2951
Mailing Address - Street 1:6666 HARWIN DR.
Mailing Address - Street 2:SUITE 345
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:832-649-2951
Mailing Address - Fax:832-649-2978
Practice Address - Street 1:6666 HARWIN DR.
Practice Address - Street 2:SUITE 345
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:832-649-2951
Practice Address - Fax:832-649-2978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
315D00000X
TX015769315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient