Organization · NPI-2

Tracy Wendy Fisher

Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Cypress, TX

NPI number1922544121
StatusActive
Last updated in NPPESMar 2, 2023

Details

NPI
1922544121
Entity type
Organization (NPI-2)
Legal business name
Tracy Wendy Fisher
Organization subpart
No
Enumeration date
Jan 11, 2017
Certification date
Mar 2, 2023
Last updated
Mar 2, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities––Yes

Other names

  • Andrea'S Home Care (Doing Business As)

Practice location

11819 Granite Manor Ln
Cypress, TX 77433-6463

Phone 832-288-0779

Mailing address

11819 Granite Manor Ln
Cypress, TX 77433-6463

Authorized official

Tracy Wendy Fisher
Owner
8328591543

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