Provider Demographics
NPI:1942017819
Name:CUSTODY CARE LLC
Entity type:Organization
Organization Name:CUSTODY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLANIYI
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIBARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-241-7874
Mailing Address - Street 1:22206 HIGHLAND KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5868
Mailing Address - Country:US
Mailing Address - Phone:432-241-7874
Mailing Address - Fax:
Practice Address - Street 1:22206 HIGHLAND KNOLLS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5868
Practice Address - Country:US
Practice Address - Phone:432-241-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management