1780627158 NPI number — FOUNDATION CAREPLUS GROUP, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780627158 NPI number — FOUNDATION CAREPLUS GROUP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOUNDATION CAREPLUS GROUP, INC
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:
OASIS HOSPICE
Provider Other Organization Name Type Code:
3
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:
1780627158
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12051 SLEEPY HOLLOW ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONROE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-607-2310
Provider Business Mailing Address Fax Number:
281-607-2314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12051 SLEEPY HOLLOW ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-607-2310
Provider Business Practice Location Address Fax Number:
281-607-2314
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
KASSANDRA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
281-607-2310

Provider Taxonomy Codes

  • Taxonomy code: 207RH0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: 010227 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 001015070 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".