Janice Marie Rideaux

Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · La Marque, TX

NPI 1376160069 · NPPES record last updated Jun 29, 2020

Key facts

NPI
1376160069
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Practice address
2402 Cedar Dr
La Marque, TX 77568-3916
Phone
(281) 508-0192
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

2402 Cedar Dr
La Marque, TX 77568-3916

Mailing address

2402 Cedar Dr
La Marque, TX 77568-3916
Phone (281) 508-0192

Other providers in La Marque, TX

All providers in La Marque, TX · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

Sources for this page

Verify at the official NPI Registry.