Provider Demographics
NPI:1902368111
Name:SUGARFRUIT PROPERTIES, LLC
Entity Type:Organization
Organization Name:SUGARFRUIT PROPERTIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEARA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-901-9142
Mailing Address - Street 1:3701 STATE HIGHWAY 150 W
Mailing Address - Street 2:
Mailing Address - City:NEW WAVERLY
Mailing Address - State:TX
Mailing Address - Zip Code:77358-5455
Mailing Address - Country:US
Mailing Address - Phone:346-901-9142
Mailing Address - Fax:
Practice Address - Street 1:3701 STATE HIGHWAY 150 W
Practice Address - Street 2:
Practice Address - City:NEW WAVERLY
Practice Address - State:TX
Practice Address - Zip Code:77358-5455
Practice Address - Country:US
Practice Address - Phone:346-901-9142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-05
Last Update Date:2023-12-30
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