Provider Demographics
NPI:1851869358
Name:WAVULI FOUNDATION
Entity Type:Organization
Organization Name:WAVULI FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-528-8959
Mailing Address - Street 1:8542 VILLAGE ROSE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-5649
Mailing Address - Country:US
Mailing Address - Phone:832-528-8959
Mailing Address - Fax:
Practice Address - Street 1:8542 VILLAGE ROSE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5649
Practice Address - Country:US
Practice Address - Phone:832-528-8959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child