Provider Demographics
NPI:1700241643
Name:PEOPLE SPECIAL PLACE LLC
Entity Type:Organization
Organization Name:PEOPLE SPECIAL PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLEMENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-867-1600
Mailing Address - Street 1:3419 FOUNTAINS DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-8793
Mailing Address - Country:US
Mailing Address - Phone:832-867-1600
Mailing Address - Fax:
Practice Address - Street 1:3419 FOUNTAINS DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-8793
Practice Address - Country:US
Practice Address - Phone:832-867-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health