Provider Demographics
| NPI: | 1932703956 |
|---|---|
| Name: | COLOSSAL INDUSTRIES LLC |
| Entity type: | Organization |
| Organization Name: | COLOSSAL INDUSTRIES LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VICE PRESIDENT |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | NICOLE |
| Authorized Official - Middle Name: | JANELL |
| Authorized Official - Last Name: | CELESTINE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 713-332-0057 |
| Mailing Address - Street 1: | 521 N SAM HOUSTON PKWY E STE 532 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77060-4056 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-332-0057 |
| Mailing Address - Fax: | 800-810-3771 |
| Practice Address - Street 1: | 521 N SAM HOUSTON PKWY E STE 532 |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77060-4056 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-332-0057 |
| Practice Address - Fax: | 800-810-3771 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-11-30 |
| Last Update Date: | 2020-11-30 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 332BN1400X | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies |
| No | 174200000X | Other Service Providers | Meals | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251E00000X | Agencies | Home Health | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 251X00000X | Agencies | Supports Brokerage | |
| No | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| No | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
| No | 332BD1200X | Suppliers | Durable Medical Equipment & Medical Supplies | Dialysis Equipment & Supplies |
| No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition |
| No | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
