Provider Demographics
NPI:1992100960
Name:ST. CHARLES HEALTH CARE
Entity type:Organization
Organization Name:ST. CHARLES HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-276-6679
Mailing Address - Street 1:234 MEYER STREET
Mailing Address - Street 2:SUITE M
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474
Mailing Address - Country:US
Mailing Address - Phone:832-276-6679
Mailing Address - Fax:
Practice Address - Street 1:234 MEYER ST
Practice Address - Street 2:SUITE M
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-2325
Practice Address - Country:US
Practice Address - Phone:832-276-6679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health