Provider Demographics
NPI:1134713803
Name:TAJ DAY HAB SERVICES
Entity type:Organization
Organization Name:TAJ DAY HAB SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBUS
Authorized Official - Middle Name:BENITOS
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-967-7500
Mailing Address - Street 1:6305 BASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3467
Mailing Address - Country:US
Mailing Address - Phone:832-235-5398
Mailing Address - Fax:281-967-7505
Practice Address - Street 1:150 PARKER CT
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-1970
Practice Address - Country:US
Practice Address - Phone:281-967-7500
Practice Address - Fax:281-967-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care