1HOUSE OF MICAH NPI 1104219096

NPI Information

NPI: 1104219096
Provider Name: 1HOUSE OF MICAH
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
600 WOODBRIDGE PKWY
UNIT 2133
WYLIE, TX
ZIP 75098
Phone: (469) 478-7106
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1HOUSE OF MICAH is an adult care home custodial care facility in Wylie, TX. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. 1HOUSE OF MICAH NPI is 1104219096. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

600 WOODBRIDGE PKWY
UNIT 2133
WYLIE, TX
ZIP 75098-047
Phone: (469) 478-7106

The provider's authorized official is Jamila Gilliam .
The authorized official title is Owner and has the following contact phone number (469) 478-7106.

The enumeration date for this NPI number is 3/17/2015 and was last updated on 3/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	104100000X	Social Worker		56214	TEXAS	No
2	251C00000X	Day Training, Developmentally Disabled Services				No
3	311Z00000X	Custodial Care Facility				No
4	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities				No
5	320700000X	Residential Treatment Facility, Physical Disabilities				No
6	320800000X	Community Based Residential Treatment Facility, Mental Illness				No
7	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				No
8	311ZA0620X	Custodial Care Facility	Adult Care Home			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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