Provider Demographics
NPI:1952685232
Name:MANIFESTATION HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MANIFESTATION HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:ORIGUEDE
Authorized Official - Last Name:OJIGHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-313-0535
Mailing Address - Street 1:1418 NEW TREE LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-4147
Mailing Address - Country:US
Mailing Address - Phone:281-313-0535
Mailing Address - Fax:281-313-0532
Practice Address - Street 1:1418 NEW TREE LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-4147
Practice Address - Country:US
Practice Address - Phone:281-313-0535
Practice Address - Fax:281-313-0532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801477700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health