Provider Demographics
NPI:1639601727
Name:SALIHU, AYODELE
Entity Type:Individual
Prefix:
First Name:AYODELE
Middle Name:
Last Name:SALIHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 GRANITE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-9280
Mailing Address - Country:US
Mailing Address - Phone:832-952-9588
Mailing Address - Fax:832-945-3715
Practice Address - Street 1:7404 TOWN CENTER BLVD
Practice Address - Street 2:APT 815
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6220
Practice Address - Country:US
Practice Address - Phone:716-408-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X, 251S00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health