Provider Demographics
NPI:1740592724
Name:BAMBINO HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BAMBINO HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BAMIDELE
Authorized Official - Middle Name:YUSUF
Authorized Official - Last Name:ADIO ODUOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-887-4183
Mailing Address - Street 1:9700 LEAWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099
Mailing Address - Country:US
Mailing Address - Phone:832-887-4183
Mailing Address - Fax:
Practice Address - Street 1:9700 LEAWOOD BLVD
Practice Address - Street 2:APT 1301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2531
Practice Address - Country:US
Practice Address - Phone:832-887-4183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management