Provider Demographics
NPI:1194493791
Name:1ST COMPASSIONATE GROUP HOME INC
Entity type:Organization
Organization Name:1ST COMPASSIONATE GROUP HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OMOLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:OJOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-533-6187
Mailing Address - Street 1:5227 MONARCH BELLE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3231
Mailing Address - Country:US
Mailing Address - Phone:124-053-3618
Mailing Address - Fax:
Practice Address - Street 1:5227 MONARCH BELLE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3231
Practice Address - Country:US
Practice Address - Phone:124-053-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities