1568827665 NPI number — MAJESTIC PERSONAL CARE SERVICES, LLC

Table of content: (NPI 1568827665)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568827665 NPI number — MAJESTIC PERSONAL CARE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAJESTIC PERSONAL CARE SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568827665
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3614 APPLE HOLLOW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUMBLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77396-3937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-818-1284
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 N SAM HOUSTON PKWY E STE 350
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77032-2974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-282-2045
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOODWIN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE ADMINISTRATOR
Authorized Official Telephone Number:
832-288-2531

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)