Provider Demographics
NPI:1043470511
Name:DOROTHY ANUGWOM
Entity type:Organization
Organization Name:DOROTHY ANUGWOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANUGWOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-975-7216
Mailing Address - Street 1:2006 COURTSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5206
Mailing Address - Country:US
Mailing Address - Phone:281-975-7216
Mailing Address - Fax:281-980-4266
Practice Address - Street 1:2006 COURTSHIRE LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5206
Practice Address - Country:US
Practice Address - Phone:281-975-7216
Practice Address - Fax:281-980-4266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services