Provider Demographics
NPI:1104679885
Name:THREE B'S HOME LIVING LLC
Entity type:Organization
Organization Name:THREE B'S HOME LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GODWIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:AMAEFULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-776-9996
Mailing Address - Street 1:PO BOX 720460
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-0460
Mailing Address - Country:US
Mailing Address - Phone:713-776-9996
Mailing Address - Fax:713-776-9994
Practice Address - Street 1:15210 MIRA VISTA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-4211
Practice Address - Country:US
Practice Address - Phone:713-776-9996
Practice Address - Fax:713-776-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home