Immaculate Living Care, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

IMMACULATE LIVING CARE, LLC

Practice address

12401 Overbrook LN
#61D
Houston, TX 77077-5859

Phone

(361) 549-2954

NPI assigned

Mar 19, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Erica Coco Embola

Title

President

Phone

(361) 549-2954

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1386061034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OVERBROOK LN",
            "address_2": "#61D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775859",
            "telephone_number": "361-549-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OVERBROOK LN",
            "address_2": "#61D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775859",
            "telephone_number": "361-549-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE LIVING CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "EMBOLA",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "COCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-549-2954",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Houston, TX
• Providers in Houston, TX by specialty
• Assisted Living Facility (Mental Illness) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.