Provider Demographics
NPI:1427665033
Name:KATY LAKES HOME CARE LLC
Entity type:Organization
Organization Name:KATY LAKES HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:
Authorized Official - Last Name:EVBUOMWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-348-6011
Mailing Address - Street 1:9810 BEACON CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-4001
Mailing Address - Country:US
Mailing Address - Phone:832-348-6011
Mailing Address - Fax:832-557-3422
Practice Address - Street 1:6907 NORTHCHESTER DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3850
Practice Address - Country:US
Practice Address - Phone:832-348-6011
Practice Address - Fax:832-557-3422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty