Provider Demographics
NPI:1396490769
Name:NADES REHAB L.L.C.
Entity type:Organization
Organization Name:NADES REHAB L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DECLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OJONTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-745-7674
Mailing Address - Street 1:4423 PALE FOX LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:832-745-7674
Mailing Address - Fax:
Practice Address - Street 1:4423 PALE FOX LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493
Practice Address - Country:US
Practice Address - Phone:832-745-7674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities