Provider Demographics
NPI:1710181235
Name:SOUTH WEST ASSOCIATION FOR THE DEVELOPMENTIALLY DISABLED INC
Entity Type:Organization
Organization Name:SOUTH WEST ASSOCIATION FOR THE DEVELOPMENTIALLY DISABLED INC
Other - Org Name:ULTIMATGE LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:NWAKAEGO
Authorized Official - Last Name:IKEAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-568-7991
Mailing Address - Street 1:PO BOX 711035
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-1035
Mailing Address - Country:US
Mailing Address - Phone:281-568-7991
Mailing Address - Fax:281-568-8125
Practice Address - Street 1:10511 BRIGHTON LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2819
Practice Address - Country:US
Practice Address - Phone:281-568-7991
Practice Address - Fax:281-568-8125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251J00000XAgenciesNursing Care
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities