Provider Demographics
NPI:1285949610
Name:CLOUDY HOME CARE
Entity type:Organization
Organization Name:CLOUDY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAVARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-269-9022
Mailing Address - Street 1:11121 STATE HIGHWAY 7 E
Mailing Address - Street 2:
Mailing Address - City:JOAQUIN
Mailing Address - State:TX
Mailing Address - Zip Code:75954-4069
Mailing Address - Country:US
Mailing Address - Phone:936-269-9022
Mailing Address - Fax:
Practice Address - Street 1:11121 HIGHWAY 7 E
Practice Address - Street 2:
Practice Address - City:JOAQUIN
Practice Address - State:TX
Practice Address - Zip Code:75954-4069
Practice Address - Country:US
Practice Address - Phone:936-269-9022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care