Provider Demographics
NPI:1841567435
Name:KALEB HEALTHCARE SERVICES,INC.
Entity Type:Organization
Organization Name:KALEB HEALTHCARE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IHUOMA
Authorized Official - Middle Name:AKUESU
Authorized Official - Last Name:AGUORU
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:512-299-1679
Mailing Address - Street 1:12318 THOMPKINS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-7016
Mailing Address - Country:US
Mailing Address - Phone:512-299-1679
Mailing Address - Fax:512-299-1679
Practice Address - Street 1:12318 THOMPKINS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-7016
Practice Address - Country:US
Practice Address - Phone:512-299-1679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-26
Last Update Date:2011-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX588402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility