Provider Demographics
NPI:1962760975
Name:TOWER OF MERCY HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:TOWER OF MERCY HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:KEHINDE
Authorized Official - Last Name:OJELADE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:713-370-1363
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:535F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:713-370-1363
Mailing Address - Fax:
Practice Address - Street 1:10333 HARWIN DR
Practice Address - Street 2:535F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1545
Practice Address - Country:US
Practice Address - Phone:713-370-1363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWER OF MERCY HEALTHCARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-27
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLVN251E00000X, 302R00000X, 385HR2060X
TX311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251E00000XAgenciesHome Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child