Provider Demographics
NPI:1891989828
Name:ADULT TOWN DAY CARE
Entity Type:Organization
Organization Name:ADULT TOWN DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUSIBAU
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-645-2300
Mailing Address - Street 1:4450 S WAYSIDE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-1126
Mailing Address - Country:US
Mailing Address - Phone:713-645-2300
Mailing Address - Fax:
Practice Address - Street 1:4450 S WAYSIDE DR STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-1126
Practice Address - Country:US
Practice Address - Phone:713-645-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WORLD WIDE CARING HOME INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003319261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003319Medicaid