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NPI Profile for EVANGELISTA C ANUGWOM in MESQUITE, TX.
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
320900000X |
| NPI Number | 1396020699 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 10/18/2011 | |
| Last updated | 10/18/2011 - About 15 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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EVANGELISTA C ANUGWOM
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EVANGELISTA C ANUGWOM, RN