Provider Demographics
NPI:1649798802
Name:GARDEN CYCLE HEALTHCARE SYSTEM, LLC
Entity type:Organization
Organization Name:GARDEN CYCLE HEALTHCARE SYSTEM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:EJIMADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-217-6952
Mailing Address - Street 1:2608 CHINABERRY PARK LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3258
Mailing Address - Country:US
Mailing Address - Phone:281-217-6952
Mailing Address - Fax:
Practice Address - Street 1:2608 CHINABERRY PARK LN
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3258
Practice Address - Country:US
Practice Address - Phone:281-217-6952
Practice Address - Fax:281-217-6952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health