Provider Demographics
NPI:1164230702
Name:HOME LIKE HEAVEN
Entity type:Organization
Organization Name:HOME LIKE HEAVEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREEMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUKWUEWUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-708-5576
Mailing Address - Street 1:6065 HILLCROFT ST STE 610
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1103
Mailing Address - Country:US
Mailing Address - Phone:281-979-7966
Mailing Address - Fax:
Practice Address - Street 1:1702 IVIE LEE ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3623
Practice Address - Country:US
Practice Address - Phone:281-979-7966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility