Provider Demographics
NPI:1689439358
Name:HEPHZIBAH HOMES LLC
Entity Type:Organization
Organization Name:HEPHZIBAH HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWASEUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-292-3132
Mailing Address - Street 1:2401 FOUNTAIN VIEW DR # 2023
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2129 WINDY GROVE DR
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77568-1326
Practice Address - Country:US
Practice Address - Phone:857-312-5831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home