Provider Demographics
NPI:1336747591
Name:HOME CARE OF HOUSTON
Entity Type:Organization
Organization Name:HOME CARE OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OTOKITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-499-9627
Mailing Address - Street 1:4119 FERRO ST
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5246
Mailing Address - Country:US
Mailing Address - Phone:832-499-9627
Mailing Address - Fax:
Practice Address - Street 1:9894 BISSONNET ST STE 100U
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8239
Practice Address - Country:US
Practice Address - Phone:832-499-9627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care