Provider Demographics
NPI:1396306262
Name:UNIQUE PRIVATE CARE CENTER
Entity type:Organization
Organization Name:UNIQUE PRIVATE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANEKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NGOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-343-0665
Mailing Address - Street 1:4548 BRISCOE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2008
Mailing Address - Country:US
Mailing Address - Phone:832-343-0665
Mailing Address - Fax:
Practice Address - Street 1:4548 BRISCOE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-2008
Practice Address - Country:US
Practice Address - Phone:832-343-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare