Provider Demographics
NPI:1972966844
Name:CARE AND LAUGHTER ASSISTED LIVING AND PROVIDER SERVICES, INC.
Entity Type:Organization
Organization Name:CARE AND LAUGHTER ASSISTED LIVING AND PROVIDER SERVICES, INC.
Other - Org Name:CARE AND LAUGHTER ASSISTED LIVING AND PROVIDER SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:OBATA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-919-6547
Mailing Address - Street 1:9706 QUEENSBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-5112
Mailing Address - Country:US
Mailing Address - Phone:281-919-6547
Mailing Address - Fax:
Practice Address - Street 1:2839 N MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5550
Practice Address - Country:US
Practice Address - Phone:832-539-1237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX431966701Medicaid