Provider Demographics
NPI:1134448954
Name:JANE MADOJUTIMI
Entity type:Organization
Organization Name:JANE MADOJUTIMI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ROSELINE
Authorized Official - Last Name:MADOJUTIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-438-5515
Mailing Address - Street 1:7419 MACZALI DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3320
Mailing Address - Country:US
Mailing Address - Phone:281-438-5515
Mailing Address - Fax:
Practice Address - Street 1:7419 MACZALI DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3320
Practice Address - Country:US
Practice Address - Phone:281-438-5515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility