Provider Demographics
NPI:1588892301
Name:ST JUDE'S DAY SERVICES
Entity type:Organization
Organization Name:ST JUDE'S DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUORAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-337-5390
Mailing Address - Street 1:3717 HWY 3
Mailing Address - Street 2:SUITE C
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539
Mailing Address - Country:US
Mailing Address - Phone:281-337-5390
Mailing Address - Fax:281-614-5788
Practice Address - Street 1:3717 HIGHWAY 3
Practice Address - Street 2:SUITE C
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8016
Practice Address - Country:US
Practice Address - Phone:281-337-5390
Practice Address - Fax:281-614-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities