DATE PREPARED: REPORT NO.: HC INFORMATION PAGE : 22 WAIVER CONTRACT AREA: 6 MRA: 030 AUSTIN TRAVIS INTEGRAL CARE

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1 INFORMATION PAGE : 22 PROVIDER: 76R A BETTER HCS HOME INC CONTRACT NUMBER : A BETTER HCS HOME INC APPLICANT CONTACT: DARCY BENFORD PHONE: (254) FAX: (254) PHYSICAL ADDRESS : 625 BRUSY CREEK, HEWITT, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 1 1 FALLS 1 MCLENNAN 8 TRAVIS 2 CONSUMERS ENROLLED STATEWIDE 25 BOSQUE PROVIDER: 79B A CHAMPION HOME AND COMMUNITY BASED SERVICES, LLC CONTRACT NUMBER : A CHAMPION HOME AND COMMUNITY BASED SERVICES LLC APPLICANT CONTACT: HENDERSON TRACE PHONE: (469) FAX: (000) PHYSICAL ADDRESS : 7937 WOODSHIRE DRIVE, DALLAS, TX CONSUMERS ENROLLED STATEWIDE 39 PROVIDER: 79E A FAIR CHOICE, INC. CONTRACT NUMBER : A FAIR CHOICE, INC. APPLICANT CONTACT: LEDESMA KRISTY NICOLE PHONE: (817) FAX: (817) PHYSICAL ADDRESS : 3017 MEDLIN DR SUITE 200, ARLINGTON, TX CONSUMERS ENROLLED STATEWIDE 41 PROVIDER: 8XA A FAMILY OF NEW BEGINNINGS INC CONTRACT NUMBER : A FAMILY OF NEW BEGINNING INC APPLICANT CONTACT: LATONIA DAVIDSON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 612 JUSTEFORD DRIVE, PFLUGERVILLE, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 4 BELL 1 GONZALES 3 TRAVIS 19 Page 1

2 WILLIAMSON 2 CONSUMERS ENROLLED STATEWIDE 37 PROVIDER: 78H A PEACE OF MIND CARE GROUP LLC CONTRACT NUMBER : A PEACE OF MIND CARE GROUP LLC APPLICANT CONTACT: KNOX JR NICK PHONE: (832) FAX: (281) PHYSICAL ADDRESS : WESTHIMER DR STE 122, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 24 PROVIDER: 7E4 A PRECIOUS PLACE FOR ME LLC CONTRACT NUMBER : A PRECIOUS PLACE FOR ME LLC APPLICANT CONTACT: MICHAEL WILSON PHONE: (253) FAX: (254) PHYSICAL ADDRESS : 3501 VIEWCREST DR, KILLEEN, TX PROVIDER: 8XC A TAP INC CONTRACT NUMBER : A TAP INC INFORMATION PAGE : 23 APPLICANT CONTACT: TONY ALEXANDER PHONE: (281) FAX: (832) PHYSICAL ADDRESS : 9118 MESA DRIVE, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 36 PROVIDER: 7CB A TEXAS HEART FOR FAMILIES INC CONTRACT NUMBER : A TEXAS HEART FOR FAMILIES INC APPLICANT CONTACT: SANDRA GONZALEZ PHONE: (214) Page 2

3 FAX: (214) PHYSICAL ADDRESS : 1001 SADDLEBROOK DR, LUCAS, TX CONSUMERS ENROLLED STATEWIDE 41 PROVIDER: 79X A TOP LINE CHOICE INC CONTRACT NUMBER : A TOP LINE CHOICE INC APPLICANT CONTACT: KAREN NAPPIER PHONE: (817) FAX: (817) PHYSICAL ADDRESS : 6705 KEELER DR, ARLINGTON, TX CONSUMERS ENROLLED STATEWIDE 16 PROVIDER: 7AE AARDVARK CENTER LLC CONTRACT NUMBER : AARDVARK CENTER LLC APPLICANT CONTACT: AJALA OLUGBENGA PHONE: (832) FAX: (713) PHYSICAL ADDRESS : BISSONNET STREET STE. 219, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 79Y ABBA UNLIMITED LLC CONTRACT NUMBER : ABBA UNLIMITED LLC APPLICANT CONTACT: EDWARDS JENNIFER PHONE: (512) FAX: (800) PHYSICAL ADDRESS : 1720 LOMITA DR, LEANDER, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: GUADALUPE 1 1 WILLIAMSON 17 CONSUMERS ENROLLED STATEWIDE 19 TRAVIS PROVIDER: 8TQ ABEL KARE CONCEPTS INC CONTRACT NUMBER : ABEL KARE CONCEPTS INC APPLICANT CONTACT: ABEL CORTEZ PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 4201 W PARMER LN STE A275, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: CALDWELL 1 17 WILLIAMSON 3 CONSUMERS ENROLLED STATEWIDE 43 TRAVIS PROVIDER: 8QT ABIDING CHOICE, INC. CONTRACT NUMBER : ABIDING CHOICE, INC. APPLICANT CONTACT: TIFFANY PARKER PHONE: (512) FAX: (512) Page 3

4 PHYSICAL ADDRESS : 213 EAST CAMERON AVENUE, ROCKDALE, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 9 BELL 81 BURLESON 1 CORYELL 5 FALLS 1 FAYETTE 2 LAMPASAS 1 LEE 16 MILAM 21 TRAVIS 13 WILLIAMSON 22 INFORMATION PAGE : 24 CONSUMERS ENROLLED STATEWIDE 230 PROVIDER: 8SH ABILITIES INC CONTRACT NUMBER : ABILITIES INC APPLICANT CONTACT: ARNULFO GONZALEZ PHONE: (972) FAX: (972) PHYSICAL ADDRESS : PASTOR BAILEY DR. STE. 101A, DALLAS, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: MCLENNAN 1 TRAVIS 1 CONSUMERS ENROLLED STATEWIDE 99 PROVIDER: 79M ABOVE ENDLESS HEIGHTS, INC CONTRACT NUMBER : ABOVE ENDLESS HEIGHTS, INC. APPLICANT CONTACT: COTTINGHAM LINDA PHONE: (214) FAX: (000) PHYSICAL ADDRESS : 1324 BAYTHORNE DRIVE, LEWISVILLE, TX CONSUMERS ENROLLED STATEWIDE 31 PROVIDER: 79W ABOVE&BEYOND HEALTHCARE SERVIC CONTRACT NUMBER : ABOVE&BEYOND HEALTHCARE SERVIC APPLICANT CONTACT: GREER TEMISHA PHONE: (214) FAX: (000) PHYSICAL ADDRESS : 2320 BLUE SMOKE CT N, FORT WORTH, TX Page 4

5 CONSUMERS ENROLLED STATEWIDE 14 PROVIDER: 7CJ AC&C HCS INC CONTRACT NUMBER : AC & C HCS INC APPLICANT CONTACT: JALOMO CATHERINE PHONE: (361) FAX: (361) PHYSICAL ADDRESS : 2502 SCABBARD DRIVE, CORPUS CHRISTI, TX CONSUMERS ENROLLED STATEWIDE 12 PROVIDER: 77Y ACCOUNTABLE SOURCE INC CONTRACT NUMBER : ACCOUNTABLE SOURCE INC APPLICANT CONTACT: SCOTT GULLESE PHONE: (713) FAX: (713) PHYSICAL ADDRESS : 3741 MANGUM ROAD, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 25 PROVIDER: 7CI ACORN HEALTHCARE SERVICES INCO CONTRACT NUMBER : ACORN HEALTHCARE SERVICES, INC APPLICANT CONTACT: ABRAHAM SARAH JANE PHONE: (281) FAX: (000) PHYSICAL ADDRESS : 3014 SILVER CEDAR TRAIL, KATY, TX CONSUMERS ENROLLED STATEWIDE 12 PROVIDER: 77F ADJACENT HEALTH CARE SERVICES CONTRACT NUMBER : ADJACENT HEALTH CARE SERVICES INFORMATION PAGE : 25 FAX: APPLICANT CONTACT: DELVERK WOODS PHONE: (972) Page 5

6 PHYSICAL ADDRESS : 1302 TEASLEY LANE, DENTON, TX CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 77B ADONAI INC CONTRACT NUMBER : ADONAI INC APPLICANT CONTACT: RYAN KIPPES PHONE: (214) FAX: (940) PHYSICAL ADDRESS : 2080 N STATE HWY 360 STE 230, GRAND PRAIRIE, TX CONSUMERS ENROLLED STATEWIDE 52 PROVIDER: 79D ADONAIS LIVING CENTER INC CONTRACT NUMBER : ADONAIS LIVING CENTER INC APPLICANT CONTACT: ANAGHARA VICORIA PHONE: (832) FAX: (832) PHYSICAL ADDRESS : COSTERO DRIVE, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 11 PROVIDER: 7DZ ADVOCATES UNITED AND COMPANY CONTRACT NUMBER : ADVOCATES UNITED AND COMPANY APPLICANT CONTACT: SANDERS KATRINA PHONE: (832) FAX: (888) PHYSICAL ADDRESS : 6671 SOUTHWEST FREEWAY STE. 300 F, HOUSTON, TX PROVIDER: 8YM AHORA Y SIEMPRE INC CONTRACT NUMBER : AHORA Y SIEMPRE INC APPLICANT CONTACT: FRANCISCO GONZALEZ PHONE: (214) FAX: (214) PHYSICAL ADDRESS : 1412 MAIN STREET STE 2500, DALLAS, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 GONZALES 2 HILL 2 TRAVIS 9 CONSUMERS ENROLLED STATEWIDE 308 PROVIDER: 894 ALLIANCE COMMUNITY CARE, LLC CONTRACT NUMBER : ALLIANCE COMMUNITY CARE, LLC APPLICANT CONTACT: IN K. HWANG PHONE: (512) FAX: (512) PHYSICAL ADDRESS : ORSOBELLO COVE, CEDAR PARK, TX Page 6

7 CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 LAMPASAS 1 TRAVIS 10 CONSUMERS ENROLLED STATEWIDE 12 PROVIDER: 8N4 ALTERNATE OPTIONS, INC. CONTRACT NUMBER : ALTERNATE OPTIONS, INC. APPLICANT CONTACT: BERNADETTE JOHNSON PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 8303 SW FREEWAY,STE 705, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 1 INFORMATION PAGE : 26 PROVIDER: 797 AMAZING LIVING HCS LLC CONTRACT NUMBER : AMAZING LIVING HCS LLC APPLICANT CONTACT: TRISTAN HOGANN PHONE: (903) FAX: (888) PHYSICAL ADDRESS : 1712 FIRST STREET EAST STE. G, HUMBLE, TX CONSUMERS ENROLLED STATEWIDE 16 PROVIDER: 7BA ANDREW M CONTRERAS III CONTRACT NUMBER : MIRCLES HAPPEN APPLICANT CONTACT: CONTRERAS I ANDREW PHONE: (210) FAX: (210) PHYSICAL ADDRESS : 2881 THOUSAND OAKS, SAN ANTONIO, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: GUADALUPE 1 CONSUMERS ENROLLED STATEWIDE 46 PROVIDER: 7C6 ANGELES DE LA TIERRA LLC CONTRACT NUMBER : ANGELES DE LA TIERRA, LLC Page 7

8 APPLICANT CONTACT: AIDEYAN JOSHUA PHONE: (318) FAX: (832) PHYSICAL ADDRESS : FAIRPOINT DRIVE, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 19 PROVIDER: 7A1 ANGELS OF COLOUR THERAPEUTIC G CONTRACT NUMBER : ANGELS OF COLOUR THERAPEUTIC GROUP HOME APPLICANT CONTACT: WILSON GAGE LATONIA PHONE: (713) FAX: (832) PHYSICAL ADDRESS : 3409 HIGHLAND POINT LANE, PEARLAND, TX CONSUMERS ENROLLED STATEWIDE 8 PROVIDER: 77A ANITA DAVIS WILCOX CONTRACT NUMBER : LIVING WITH PURPOSE APPLICANT CONTACT: ANITA WILCOX PHONE: (817) FAX: PHYSICAL ADDRESS : PLEASANTWOOD LN, FORT WORTH, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 1 CONSUMERS ENROLLED STATEWIDE 27 PROVIDER: 8WQ APPLIED LIVING SOLUTIONS LLC CONTRACT NUMBER : APPLIED LIVING SOLUTIONS LLC APPLICANT CONTACT: CYNDY BURLESON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 221 CR 4748, KEMPNER, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 BELL 5 CORYELL 5 LAMPASAS 1 TRAVIS 10 CONSUMERS ENROLLED STATEWIDE 26 PROVIDER: 87W APPROVED QUALITY CARE TEXAS,INC. CONTRACT NUMBER : APPROVED QUALITY CARE TEXAS,INC. Page 8

9 INFORMATION PAGE : 27 APPLICANT CONTACT: GERALD A. CHAVEZ PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 4024 IDALIA, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 17 CALDWELL 1 GUADALUPE 2 LEE 8 TRAVIS 10 WILLIAMSON 3 CONSUMERS ENROLLED STATEWIDE 101 PROVIDER: 7BW ASSURANCE PERSONAL CARE & COMM CONTRACT NUMBER : ASSURANCE PERSONAL CARE & COMMUNITY SERVICES INC. APPLICANT CONTACT: NWOKORIE JOHNSON PHONE: (281) FAX: (713) PHYSICAL ADDRESS : MOSS BARK TRAIL, RICHMOND, TX PROVIDER: 8ZG ASSURED QUALITY CARE SERVICES CONTRACT NUMBER : ASSURED QUALITY CARE HCS SERVICES APPLICANT CONTACT: STACY WILLIAMS ROSS PHONE: (936) FAX: (281) PHYSICAL ADDRESS : 7544 FM 1960 EAST #352, HUMBLE, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: LEON 2 MCLENNAN 1 CONSUMERS ENROLLED STATEWIDE 59 PROVIDER: 816 AUTISTIC TREATMENT CENTER INC CONTRACT NUMBER : AUTISTIC TREATMENT CENTER INC APPLICANT CONTACT: ANNA HUNDLEY PHONE: (972) FAX: (972) PHYSICAL ADDRESS : METRIC DR, DALLAS, TX CONSUMERS ENROLLED STATEWIDE 30 PROVIDER: 8SU BECK AND JOHNSON COMMUNITY SERVICES CONTRACT NUMBER : BECK AND JOHNSON COMMUNITY SERVICES APPLICANT CONTACT: JOHNSON CASSANDRA PHONE: (713) FAX: (281) PHYSICAL ADDRESS : 6401 BINGLE STE 106, HOUSTON, TX Page 9

10 CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 8EF BELLTECH ENTERPRISES, INC. CONTRACT NUMBER : BELLTECH ENTERPRISES,INC. APPLICANT CONTACT: RAFFY BELL PHONE: (281) FAX: (281) PHYSICAL ADDRESS : RICHMOND AVE, STE 130, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 41 PROVIDER: 88G BERRY FAMILY SERVICES, INC. CONTRACT NUMBER : BERRY FAMILY SERVICES, INC. APPLICANT CONTACT: BERRY CINDY PHONE: (972) FAX: (972) PHYSICAL ADDRESS : 5700 ROWLETT DR #110, ROWLETT, TX CONSUMERS ENROLLED STATEWIDE 1010 INFORMATION PAGE : 28 PROVIDER: 8CY BETHESDA LUTHERAN HOMES AND SERVICES, INC. CONTRACT NUMBER : BETHESDA LUTHERAN HOMES AND SERVICES, INC. APPLICANT CONTACT: TAMICO MELVIN PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 729, CYPRESS, TX CONSUMERS ENROLLED STATEWIDE 58 PROVIDER: 7CM BLEU ARC INC CONTRACT NUMBER : BLEU ARC INC APPLICANT CONTACT: EMMANUEL ADAORA PHONE: (832) FAX: (832) Page 10

11 PHYSICAL ADDRESS : NORWICH GARDENS LANE, FULSHEAR, TX CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 8T4 BRANDON TRIMONE MODKINS CONTRACT NUMBER : BRANDON TRIMONE MODKINS APPLICANT CONTACT: JULIA KANTER PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 8606 DANDELION TRL, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 2 BELL 2 TRAVIS 13 WILLIAMSON 4 CONSUMERS ENROLLED STATEWIDE 21 PROVIDER: 76Y BRENDA L DICKENS CONTRACT NUMBER : BRENDA L DICKENS APPLICANT CONTACT: BRENDA DICKENS PHONE: (281) FAX: PHYSICAL ADDRESS : 6619 INDIAN FALLS DR, MISSOURI CITY, TX PROVIDER: 76T CAROLINE CHEEVERS CONTRACT NUMBER : CAROLINE CHEEVERS APPLICANT CONTACT: CHEEVERS CAROLINE PHONE: (832) FAX: (832) PHYSICAL ADDRESS : 6034 WILLOWBEND BLVD., HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 8VH CASA ESPERANZA INC CONTRACT NUMBER : HOPE HOUSE APPLICANT CONTACT: DAWN HAMILTON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : COUNTY ROAD 285, LIBERTY HILL, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: WILLIAMSON 15 CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 7DJ CHARLOTTE BOSTON SCOTT CONTRACT NUMBER : JOYFUL DAYS Page 11

12 INFORMATION PAGE : 29 APPLICANT CONTACT: CHARLOTTE SCOTT PHONE: (800) FAX: (318) PHYSICAL ADDRESS : 508 GLENWICK DR, DESOTO, TX PROVIDER: 7AH CHOSEN J X INCORPORATED CONTRACT NUMBER : CHOSEN J X INCORPORATED APPLICANT CONTACT: SADIQ MAUREEN PHONE: (281) FAX: (832) PHYSICAL ADDRESS : BELLAIRE BLVD STE C, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 82A CHUCK C. OKEADU CONTRACT NUMBER : SPECIAL HOME CARE LIVING CENTER APPLICANT CONTACT: OKEADU CHUCK PHONE: (713) FAX: (000) PHYSICAL ADDRESS : 9898 BISSONNET ST, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 30 PROVIDER: 7DK CITI HEALTH GROUP INC CONTRACT NUMBER : CITI HEALTH GROUP INC APPLICANT CONTACT: DANIEL O. ORJI PHONE: (346) FAX: (832) PHYSICAL ADDRESS : 8303 SOUTH WEST FREEWAY STE. 100, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 1 PROVIDER: 86D CLETUS O OKONKWO CONTRACT NUMBER : ULTIMATE LIVING CENTER APPLICANT CONTACT: CLETUS O. OKONKWO PHONE: (281) Page 12

13 FAX: (281) PHYSICAL ADDRESS : BELLAW WOODS DRIVE, HUMBLE, TX CONSUMERS ENROLLED STATEWIDE 5 PROVIDER: 837 COMMUNITY ACCESS INC CONTRACT NUMBER : COMMUNITY ACCESS II APPLICANT CONTACT: TONYA MOSES PHONE: (903) FAX: (903) PHYSICAL ADDRESS : 2040 SHILOH ROAD, TYLER, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: MCLENNAN 1 CONSUMERS ENROLLED STATEWIDE 519 PROVIDER: 8BT COMMUNITY CHOICE INCORPORATED CONTRACT NUMBER : COMMUNITY CHOICE INCORPORATED APPLICANT CONTACT: TOM CONROY PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 9609 NEW FOUNDLAND CIRCLE, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 GUADALUPE 1 TRAVIS 32 WILLIAMSON 14 CONSUMERS ENROLLED STATEWIDE 47 INFORMATION PAGE : 30 PROVIDER: 830 COMMUNITY OPTIONS, INC. CONTRACT NUMBER : COMMUNITY OPTIONS OF TEXAS APPLICANT CONTACT: DEANNA ABRAHAM PHONE: (972) FAX: (972) PHYSICAL ADDRESS : RESEARCH BLVD UNIT C300, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: GUADALUPE 1 31 WILLIAMSON 2 CONSUMERS ENROLLED STATEWIDE 446 Page 13 TRAVIS

14 PROVIDER: 7D5 CORINTHIA LILLIE ALFORD CONTRACT NUMBER : RUTHERFORD ENTERPRISE APPLICANT CONTACT: CORINTHIA L ALFORD PHONE: (972) FAX: (888) PHYSICAL ADDRESS : 4013 EASTON MEADOWS DR#101, GARLAND, TX PROVIDER: 8GU COUNCIL OAKS COMMUNITY OPTIONS, LTD. CONTRACT NUMBER : COUNCIL OAKS COMMUNITY OPTIONS, LTD. APPLICANT CONTACT: CHRISTINA PORTILLO PHONE: (210) FAX: (210) PHYSICAL ADDRESS : TOEPPERWEIN RD STE 1001, SAN ANTONIO, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: GUADALUPE 2 CONSUMERS ENROLLED STATEWIDE 31 PROVIDER: 7BY CYANN CENTER LLC CONTRACT NUMBER : CYANN CENTER LLC APPLICANT CONTACT: FORD KARLA PHONE: (713) FAX: (800) PHYSICAL ADDRESS : 112 S. GORDON STREET, ALVIN, TX CONSUMERS ENROLLED STATEWIDE 11 PROVIDER: 7A8 CYNTHIA A EJIMADU CONTRACT NUMBER : JARU HOME AND COMMUNITY SERVICES APPLICANT CONTACT: CYNTHIA EJIMADU PHONE: (832) FAX: (281) PHYSICAL ADDRESS : 9896 BISSONNET STE. 155, HOUSTON, TX PROVIDER: 891 D & S RESIDENTIAL SERVICES, LP CONTRACT NUMBER : D & S COMMUNITY SERVICES APPLICANT CONTACT: JOELLE BART PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 225 S COMMONS FORD RD, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 26 BELL 7 BRAZOS 65 BURLESON 2 BURNET 9 CALDWELL 19 FAYETTE 3 FREESTONE 2 GONZALES 2 GRIMES 7 GUADALUPE 21 LEE 1 MCLENNAN 2 MILAM Page 14

15 1 ROBERTSON 2 TRAVIS 179 WASHINGTON 113 WILLIAMSON 64 CONSUMERS ENROLLED STATEWIDE 1482 INFORMATION PAGE : 31 PROVIDER: 7CP DAYBREAK COMMUNITY SERVICES TEXAS CONTRACT NUMBER : DAYBREAK COMMUNITY SERVICES TEXAS LLC APPLICANT CONTACT: JOLYNN DUNN PHONE: (254) FAX: (254) PHYSICAL ADDRESS : 500 SPARTA ROAD, BELTON, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 66 BOSQUE 3 BRAZOS 31 BURLESON 3 CALDWELL 1 CORYELL 2 FREESTONE 4 GRIMES 2 GUADALUPE 6 HAMILTON 1 LAMPASAS 1 LEE 1 LEON 3 LIMESTONE 11 MCLENNAN 27 ROBERTSON 1 TRAVIS 1 CONSUMERS ENROLLED STATEWIDE 1450 PROVIDER: 8XL DIVERSIFIED CARING HOMES PLLC CONTRACT NUMBER : DIVERSIFIED CARING HOMES PLLC APPLICANT CONTACT: RENETTA HILLS PHONE: (832) FAX: (832) PHYSICAL ADDRESS : FLEETHAVEN LANE, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 23 PROVIDER: 8ST DORA BRYANT ALLISON CONTRACT NUMBER : REACHING OUT RESIDENTIAL SERVICES APPLICANT CONTACT: ALLISON DORA PHONE: (903) FAX: (903) PHYSICAL ADDRESS : 404 W. GARFIELD, LONGVIEW, TX Page 15

16 CONSUMERS ENROLLED STATEWIDE 20 PROVIDER: 805 DOUBLETREE RESIDENTIAL SERVICES, INC. CONTRACT NUMBER : DOUBLETREE RESIDENTIAL SERVICES, INC. APPLICANT CONTACT: TERESA J. GREENHAW PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 3225 W SLAUGHTER LANE, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 49 CONSUMERS ENROLLED STATEWIDE 49 PROVIDER: 8DW DRACO SERVICES, INC. CONTRACT NUMBER : DRACO SERVICES, INC. APPLICANT CONTACT: GORDON ISRAEL PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 4025 MANCHACA RD, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 10 BURNET 1 CALDWELL 13 GONZALES 6 GUADALUPE 2 LEE 1 TRAVIS 134 WILLIAMSON 43 CONSUMERS ENROLLED STATEWIDE 314 PROVIDER: 87D EDDIE ELLIS CONTRACT NUMBER : EDDIE ELLIS APPLICANT CONTACT: DORIS BENJAMIN PHONE: (254) FAX: PHYSICAL ADDRESS : RT 1 BOX 187 FM 147, MARLIN, TX PROVIDER: 804 EDUCARE COMMUNITY LIVING CORPORATION TEXAS INFORMATION PAGE : 32 Page 16

17 CONTRACT NUMBER : EDUCARE COMMUNITY LIVING CORPORATION TEXAS APPLICANT CONTACT: ANNETTE JOHNSON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 7700 CHEVY CHASE, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 BURNET 1 CALDWELL 4 FREESTONE 1 GUADALUPE 3 HILL 2 TRAVIS 112 WILLIAMSON 21 CONSUMERS ENROLLED STATEWIDE 1098 PROVIDER: 831 EDUCARE COMMUNITY LIVING NORMAL LIFE INC CONTRACT NUMBER : EDUCARE COMMUNITY LIVING NORMAL LIFE INC APPLICANT CONTACT: ANNETTE L. JOHNSON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 8007 BURNET RD, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 58 2 FALLS 1 LIMESTONE 5 MCLENNAN 8 CONSUMERS ENROLLED STATEWIDE 218 BOSQUE PROVIDER: 85M EXCEPTIONAL EMPLOYMENT SERVICES, INC. CONTRACT NUMBER : EXCEPTIONAL EMPLOYMENT SERVICES APPLICANT CONTACT: KIMBERLY STEVENSON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : RIDGEPOINT DRIVE #140, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: GONZALES 3 73 WILLIAMSON 1 CONSUMERS ENROLLED STATEWIDE 87 TRAVIS PROVIDER: 7DA FELICIA SHYNETT CONTRACT NUMBER : STEPHENS COMMUNITY LIVING HCS APPLICANT CONTACT: FELICIA SHYNETT PHONE: (469) FAX: (210) PHYSICAL ADDRESS : 513 DAVIS DR, DESOTO, TX PROVIDER: 86H FLORENCE BENNETT CONTRACT NUMBER : DIVINITY CARE CENTER APPLICANT CONTACT: FLORENCE BENNETT PHONE: (713) FAX: (281) PHYSICAL ADDRESS : P. O. BOX , HOUSTON, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: MADISON 1 Page 17

18 CONSUMERS ENROLLED STATEWIDE 7 PROVIDER: 8XD FOREVER FAMILIES INC CONTRACT NUMBER : FOREVER FAMILIES INC APPLICANT CONTACT: SOPHIA FIELDS PHONE: (713) FAX: (713) PHYSICAL ADDRESS : HWY 6 STE A, FRESNO, TX CONSUMERS ENROLLED STATEWIDE 23 PROVIDER: 78J FOUNTAIN COUNSELING AND DEVELO CONTRACT NUMBER : FOUNTAIN HEALTH CARE SERVICES APPLICANT CONTACT: FOUNTAIN AKONDYE PHONE: (832) FAX: (713) PHYSICAL ADDRESS : KATY FREEWAY, STE.428, HOUSTON, TX INFORMATION PAGE : 33 CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 7EE GENESIS DISABILITY CARE PROVID CONTRACT NUMBER : GENESIS DISABILITY CARE PROVIDER INC APPLICANT CONTACT: BAKER SHARON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 1003 VINTAGE DR, LEANDER, TX PROVIDER: 852 GOLDEN RULE SERVICES, INC CONTRACT NUMBER : GOLDEN RULE SERVICES, INC APPLICANT CONTACT: BARBARA ARMOND PHONE: (281) FAX: (281) Page 18

19 PHYSICAL ADDRESS : 3801 LIBERTY DRIVE, PEARLAND, TX CONSUMERS ENROLLED STATEWIDE 197 PROVIDER: 8RN GOOD HOME COMMUNITY LIVING INC CONTRACT NUMBER : GOOD HOME COMMUNITY LIVING INC APPLICANT CONTACT: GAIL CUNNINGHAM PHONE: (281) FAX: (866) PHYSICAL ADDRESS : 2254 COUNTY ROAD 179, ALVIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 9 15 WILLIAMSON 12 CONSUMERS ENROLLED STATEWIDE 156 TRAVIS PROVIDER: 77P GREAT BEGINNINGS CAREER COUNSELING AND LIFE COACHING CONTRACT NUMBER : GREAT BEGINNINGS CAREER COUNSELING AND APPLICANT CONTACT: LEWIS LATASHA PHONE: (504) FAX: (215) PHYSICAL ADDRESS : PLEASANT KNOLL LN, CYPRESS, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BURNET 1 CONSUMERS ENROLLED STATEWIDE 16 PROVIDER: 7E3 GREAT LIFE SERVICES LLC CONTRACT NUMBER : GREAT LIFE SERIVCES, LLC APPLICANT CONTACT: GUARDIOLA MARY PHONE: (210) FAX: (210) PHYSICAL ADDRESS : STONEY GLADE, SAN ANTONIO, TX PROVIDER: 7DG GUARDIAN ANGELS GROUP HOME LLC CONTRACT NUMBER : GUARDIAN ANGELS SERVICES APPLICANT CONTACT: JOSHUA N. KARIUKI PHONE: (469) FAX: (972) PHYSICAL ADDRESS : 426 BIRCH LANE, RICHARDSON, TX PROVIDER: 7CG HEAVEN ON EARTH LLC Page 19

20 INFORMATION PAGE : 34 CONTRACT NUMBER : HEAVEN ON EARTH LLC APPLICANT CONTACT: ANTHONY CASHUNA PHONE: (832) FAX: (346) PHYSICAL ADDRESS : 3014 ST. EMANUEL, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 1 PROVIDER: 819 HIGHER DIMENSIONAL FELLOWSHIP CONTRACT NUMBER : HIGHER DIMENSIONAL FELLOWSHIP APPLICANT CONTACT: SMITH STEVEN PHONE: (972) FAX: (000) PHYSICAL ADDRESS : 4230 ROSEHILL, GARLAND, TX CONSUMERS ENROLLED STATEWIDE 24 PROVIDER: 82I HILL COUNTRY SAN ANTONIO MANAGEMENT INC CONTRACT NUMBER : HILL COUNTRY SAN ANTONIO MANAGEMENT INC. APPLICANT CONTACT: KELLY DENTON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : FM 1626, MANCHACA, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 3 BURNET 1 TRAVIS 14 WILLIAMSON 9 CONSUMERS ENROLLED STATEWIDE 189 PROVIDER: 7D4 IMAGINE ART, INCORPORATED CONTRACT NUMBER : IMAGINE ART, INCORPORATED APPLICANT CONTACT: KIZER DEBBIE PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 2830 REAL STREET, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 3 CONSUMERS ENROLLED STATEWIDE 3 PROVIDER: 78N INGRID HINOJOSA PC CONTRACT NUMBER : IH SOLUTIONS Page 20

21 APPLICANT CONTACT: HINOJOSA INGRID PHONE: (817) FAX: (817) PHYSICAL ADDRESS : 6080 S HULEN ST STE 360, FT WORTH, TX CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 8QN ISSAC D EARLS CONTRACT NUMBER : CONNECTING LIVES SERVICES APPLICANT CONTACT: ISSAC D. EARLS PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 1514 ED BLUESTEIN BLVD. SUITE 305, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BRAZOS 1 18 WILLIAMSON 1 CONSUMERS ENROLLED STATEWIDE 21 TRAVIS PROVIDER: 88V IVY REIGN SUPPORT SERVICES CONTRACT NUMBER : IVY REIGN SUPPORT SERVICES APPLICANT CONTACT: TERRENCE TOLIVER PHONE: (254) FAX: (254) PHYSICAL ADDRESS : 2029 WASHINGTON AVE, WACO, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 4 FALLS 4 HILL 2 LAMPASAS 2 INFORMATION PAGE : 35 LIMESTONE 1 MCLENNAN 35 WILLIAMSON 1 CONSUMERS ENROLLED STATEWIDE 69 PROVIDER: 8TM JOSEPH M OKORO CONTRACT NUMBER : JOSEPH M. OKORO APPLICANT CONTACT: JOSEPH M. OKORO PHONE: (512) FAX: PHYSICAL ADDRESS : BLUFF BEND DRIVE, AUSTIN, TX Page 21

22 PROVIDER: 783 KAYLAN HENDERSON CONTRACT NUMBER : AJ & ASSOCIATES APPLICANT CONTACT: KAYLAN HENDERSON PHONE: (713) FAX: (281) PHYSICAL ADDRESS : 5217 JACKSON, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 3 PROVIDER: 8P7 KEISHA M. ROBINSON CONTRACT NUMBER : QUALITY OF CARE SERVICES APPLICANT CONTACT: KEISHA ROBINSON PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 1025 E. MAIN STREET,STE 103, LEAGUE CITY, TX CONSUMERS ENROLLED STATEWIDE 32 PROVIDER: 8CM KEITH MARTEL TAYLOR CONTRACT NUMBER : KES CARE CENTER APPLICANT CONTACT: SHERYL P. HOSEA PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 440 BENMAR #1225, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 19 PROVIDER: 85D KENMAR RESIDENTIAL HCS SERVICES INC CONTRACT NUMBER : KENMAR RESIDENTIAL HCS SERVICES INC APPLICANT CONTACT: TRACY D. ANDREWS PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 13581_RESEARCH BLVD BLDG1, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 4 FAYETTE 2 GONZALES 3 LEE 4 TRAVIS 34 WILLIAMSON 67 CONSUMERS ENROLLED STATEWIDE 136 PROVIDER: 87B LIFE CHOICES UNLIMITED, INC. CONTRACT NUMBER : LIFE CHOICES UNLIMITED,INC. APPLICANT CONTACT: SERGIO CASTILLO PHONE: (888) FAX: (877) PHYSICAL ADDRESS : 608 S. JACKSON RD., EDINBURG, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 2 CONSUMERS ENROLLED STATEWIDE 176 Page 22

23 INFORMATION PAGE : 36 PROVIDER: 8QX LIFETIME LIVING INC CONTRACT NUMBER : LIFETIME LIVING, INC APPLICANT CONTACT: DALINDA DANIELS PHONE: (210) FAX: (210) PHYSICAL ADDRESS : 5425 N LOOP 1604 E, SAN ANTONIO, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 1 GONZALES 1 GUADALUPE 22 TRAVIS 3 CONSUMERS ENROLLED STATEWIDE 629 PROVIDER: 7B5 LINDA F DIXON CONTRACT NUMBER : DIVINE COMMUNITY BASED SERVICES APPLICANT CONTACT: LINDA F DIXON PHONE: (817) FAX: PHYSICAL ADDRESS : 2504 RUGER DRIVE #55, ARLINGTON, TX CONSUMERS ENROLLED STATEWIDE 1 PROVIDER: 8ZW LIVINGMIND PROJECT INCORPORATE CONTRACT NUMBER : LIVINGMIND PROJECT INCORPORATE APPLICANT CONTACT: NWOJO SAMUEL PHONE: (281) FAX: (281) PHYSICAL ADDRESS : WESTHEIMER ROAD, SUITE 100, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 21 PROVIDER: 8BG LUCKY HEALTH CARE SERVICES INC. CONTRACT NUMBER : LUCKY HEALTH CARE SERVICES INC. APPLICANT CONTACT: DANIEL OSUAGWU PHONE: (713) Page 23

24 FAX: (713) PHYSICAL ADDRESS : FONDREN, SUITE 460, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 10 PROVIDER: 8SQ MAOFU HOME HEALTH CARE SERVICE CONTRACT NUMBER : MAOFU HOME HEALTH CARE SERVICES, INC. APPLICANT CONTACT: LUCAS TAMBE PHONE: (512) FAX: (737) PHYSICAL ADDRESS : 7901 CAMERON ROAD, BLDG 3 SUITE 139, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 1 27 WILLIAMSON 4 CONSUMERS ENROLLED STATEWIDE 50 TRAVIS PROVIDER: 8B2 MARK I RESIDENTIAL SERVICES INC CONTRACT NUMBER : MARK I RESIDENTIAL SERVICES INC. APPLICANT CONTACT: MARK HENSON PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 2130 GOODRICH AVE., AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 21 CONSUMERS ENROLLED STATEWIDE 21 PROVIDER: 8CR MARY LEE FOUNDATION CONTRACT NUMBER : MARY LEE FOUNDATION SOUTHPOINTE APPLICANT CONTACT: LEIGH DUNSON, PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 1336 LAMAR SQUARE DRIVE, AUSTIN, TX INFORMATION PAGE : 37 CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 67 CONSUMERS ENROLLED STATEWIDE 92 Page 24

25 PROVIDER: 789 MARY WEDDINGTON CONTRACT NUMBER : MARY WEDDINGTON APPLICANT CONTACT: MARY WEDDINGTON PHONE: (210) FAX: (210) PHYSICAL ADDRESS : 4931 MESA BONITA, SAN ANTONIO, TX CONSUMERS ENROLLED STATEWIDE 7 PROVIDER: 78V MENA HEALTH INC CONTRACT NUMBER : MENA HEALTH HCS APPLICANT CONTACT: NWORDU CHIKAODI PHONE: (713) FAX: (866) PHYSICAL ADDRESS : 5707 EDGEMOOR DRIVE, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 26 PROVIDER: 87S MOSAIC CONTRACT NUMBER : MOSAIC APPLICANT CONTACT: JENNIFFER LEDOUX PHONE: (281) FAX: (844) PHYSICAL ADDRESS : KUYKENDAHL STE 220, SPRING, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 23 BRAZOS 20 CORYELL 2 FALLS 6 GUADALUPE 15 HAMILTON 1 LAMPASAS 4 LEE 1 LIMESTONE 3 MCLENNAN 53 MADISON 3 ROBERTSON 2 TRAVIS 2 WILLIAMSON 3 CONSUMERS ENROLLED STATEWIDE 583 PROVIDER: 7CT N G & B ENTERPRISE INC CONTRACT NUMBER : N G & B ENTERPRISE INC APPLICANT CONTACT: PERCY BENTLEY PHONE: (713) FAX: PHYSICAL ADDRESS : 711 MARTIN LANE, MISSOURI CITY, TX CONSUMERS ENROLLED STATEWIDE 23 PROVIDER: 844 NEWSTART HCS, INC. CONTRACT NUMBER : HCS OF NORTH TEXAS APPLICANT CONTACT: ANNE SETTLE PHONE: (817) FAX: (817) PHYSICAL ADDRESS : 2755 ALTA MESA, FORT WORTH, TX CONSUMERS ENROLLED STATEWIDE 64 Page 25

26 PROVIDER: 8YC NKEIRU PRISCA UCHEM CONTRACT NUMBER : GRACEFUL CARE CENTER APPLICANT CONTACT: NKEIRU PRISCA, UCHE PHONE: (832) FAX: (281) PHYSICAL ADDRESS : HAVENRIDGE DR., HOUSTON, TX INFORMATION PAGE : 38 PROVIDER: 7D1 N2 CARE SERVICES INC CONTRACT NUMBER : N2 CARE SERVICES INC APPLICANT CONTACT: IKE ALARIBE PHONE: (832) FAX: (281) PHYSICAL ADDRESS : 5827 CRESTVIEW COVE, RICHMOND, TX CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 8NY OLUGBENGA AJALA CONTRACT NUMBER : BAYOU HEALTH CARE APPLICANT CONTACT: OLUGBENGA AJALA PHONE: (713) FAX: (713) PHYSICAL ADDRESS : BISSONENT ST,STE 219, HOUSTON, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 1 CONSUMERS ENROLLED STATEWIDE 10 PROVIDER: 8US PEPPERTREE COMPLETE CARE LLC CONTRACT NUMBER : PEPPERTREE COMPLETE CARE LLC APPLICANT CONTACT: KINA JEFFERSON PHONE: (832) FAX: PHYSICAL ADDRESS : LONGWOOD GARDEN WAY, HOUSTON, TX Page 26

27 CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 2 CONSUMERS ENROLLED STATEWIDE 6 PROVIDER: 7B7 PHILOMENA EKWEALOR CONTRACT NUMBER : DBA REAL COMFORT LIVING APPLICANT CONTACT: PHILOMENA EKWEALOR PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 1138 TURTLE CREEK DR, MISSOURI CITY, TX CONSUMERS ENROLLED STATEWIDE 1 PROVIDER: 808 PREMIEANT INCORPORATED CONTRACT NUMBER : PREMIEANT INCORPORATED APPLICANT CONTACT: JEFF ENGELKE PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 1110 W. WILLIAM CANNON BLDG 2, AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 48 CONSUMERS ENROLLED STATEWIDE 345 PROVIDER: 7D7 RACHEAL BRANCH CONTRACT NUMBER : APPROVED HEALTHCARE APPLICANT CONTACT: RACHEAL BRANCH PHONE: (832) FAX: PHYSICAL ADDRESS : CANYON RIDGE CT, SPRING, TX PROVIDER: 8CD REACHING MAXIMUM INDEPENDENCE, INC. CONTRACT NUMBER : REACHING MAXIMUM INDEPENDENCE APPLICANT CONTACT: SARA RIDEOUT PHONE: (210) FAX: (210) PHYSICAL ADDRESS : 6336 MONTGOMERY, SAN ANTONIO, TX INFORMATION PAGE : 39 Page 27

28 CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 1 CONSUMERS ENROLLED STATEWIDE 55 PROVIDER: 8YH ROBERT S MORRIS CONTRACT NUMBER : REGENCY CARE HOME APPLICANT CONTACT: ROBERT MORRIS PHONE: (512) FAX: PHYSICAL ADDRESS : CROOKED STICK DR, PFLUGERVILLE, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BASTROP 1 BELL 1 BURNET 2 TRAVIS 7 WILLIAMSON 9 CONSUMERS ENROLLED STATEWIDE 20 PROVIDER: 856 ROCK HOUSE SUPPORT SERVICES, INC. CONTRACT NUMBER : ROCK HOUSE SUPPORT SERVICES APPLICANT CONTACT: MICHELLE WRIGHT PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 6920 WILLIAMS DR, GEORGETOWN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: WILLIAMSON 50 CONSUMERS ENROLLED STATEWIDE 365 PROVIDER: 79J ROSY IN HOME SERVICES INC CONTRACT NUMBER : ROSY IN HOME SERVICES, INC. APPLICANT CONTACT: UZUH ROSEMARY PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 3724 AIRPORT BLVD., AUSTIN, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 5 CONSUMERS ENROLLED STATEWIDE 5 PROVIDER: 8Z1 S&E ENTERPRISE LLC CONTRACT NUMBER : S&E ENTERPRISE LLC APPLICANT CONTACT: SEDALIA RICE PHONE: (832) FAX: (832) PHYSICAL ADDRESS : NORTHWEST FREEWAY SUITE 180, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 39 PROVIDER: 879 SANDRA CORNELIUS CONTRACT NUMBER : SANDRA CORNELIUS APPLICANT CONTACT: SANDRA CORNELIUS PHONE: (713) FAX: (713) Page 28

29 PHYSICAL ADDRESS : 2804 HOLLY HALL, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 6 PROVIDER: 7DB SHAREL SULLIVAN CONTRACT NUMBER : THE HARMONY PLACE HOME APPLICANT CONTACT: SULLIVAN SHAREL PHONE: (972) FAX: (972) PHYSICAL ADDRESS : CHINA LAKE DR, DALLAS, TX CONSUMERS ENROLLED STATEWIDE 3 INFORMATION PAGE : 40 PROVIDER: 7AG SPETAKO CARE GROUP INC CONTRACT NUMBER : SPETAKO CARE GROUP, INC. APPLICANT CONTACT: EWURHIE SAMUEL PHONE: (281) FAX: (281) PHYSICAL ADDRESS : HARWIN DR SUITE 128, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 26 PROVIDER: 8QU SPLENDOR HILLS INCORPORATED CONTRACT NUMBER : SPLENDOR HILLS RESIDENTIAL SERVICES APPLICANT CONTACT: EDOLOROSE AZENABOR PHONE: (214) FAX: (972) PHYSICAL ADDRESS : 2306 OAK LANE, SUITE 202, GRAND PRAIRIE, TX CONSUMERS ENROLLED STATEWIDE 5 PROVIDER: 8UI SUPPORTING FAMILIES FIRST LLC CONTRACT NUMBER : SUPPORTING FAMILIES FIRST LLC Page 29

30 APPLICANT CONTACT: LENNE BRYANT PHONE: (832) FAX: (281) PHYSICAL ADDRESS : GABLE CROSSING DRIVE, RICHMOND, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: TRAVIS 1 CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 7CX TAB INTERNATIONAL INC CONTRACT NUMBER : TAB INTERNATIONAL INC APPLICANT CONTACT: BALOGUN ABAYOMI PHONE: (713) FAX: (713) PHYSICAL ADDRESS : FONDREN ROAD STE 428, HOUSTON, TX PROVIDER: 7DY TGI BROOKSTREET INC CONTRACT NUMBER : TGI BROOKSTREET INC APPLICANT CONTACT: OLUMIDE ADEBOWALE PHONE: (832) FAX: (281) PHYSICAL ADDRESS : 114 E ALAMO ST SUITE 33, BRENHAM, TX PROVIDER: 83E THOMAS AND LEWIN ASSOCIATES, INC. CONTRACT NUMBER : QUALITY CARE COMMUNITY SEVICES APPLICANT CONTACT: ATHENA THOMAS PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 2025 AVENUE G, ROSENBERG, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BRAZOS 1 1 WASHINGTON 9 CONSUMERS ENROLLED STATEWIDE 78 GRIMES PROVIDER: 8ZD THREE B'S HEALTH SOLUTIONS INC CONTRACT NUMBER : THREE B'S ASSISTED LIVING APPLICANT CONTACT: PATRICIA AMAEFULE PHONE: (713) FAX: (888) PHYSICAL ADDRESS : 9800 CENTRE PARKWAY SUITE 260A, HOUSTON, TX Page 30

31 INFORMATION PAGE : 41 CONSUMERS ENROLLED STATEWIDE 3 PROVIDER: 7DU TIANA JEANETTE SCOGGINS CONTRACT NUMBER : ST CHOICE HOMES APPLICANT CONTACT: SCOGGINS TIANA PHONE: (832) FAX: (832) PHYSICAL ADDRESS : OXHILL CT, SPRING, TX CONSUMERS ENROLLED STATEWIDE 4 PROVIDER: 7DW TOTAL CARE HOME HEALTH INC CONTRACT NUMBER : TOTAL CARE HOME HEALTH INC APPLICANT CONTACT: ELIZABETH HALLMOTEN PHONE: (512) FAX: (512) PHYSICAL ADDRESS : 8237 AREZZO DR, ROUND ROCK, TX PROVIDER: 77N VERICON HEALTH RESOURCES LLC CONTRACT NUMBER : VERICON HEALTH RESOURCES LLC APPLICANT CONTACT: JORFUI K DABO PHONE: (281) FAX: (281) PHYSICAL ADDRESS : 5202 EMORY MILL RD, RICHMOND, TX CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 83C VIRGINIA R THURMAN CONTRACT NUMBER : CLYDIES PLACE APPLICANT CONTACT: VIRGINIA R. THURMAN PHONE: (903) FAX: (903) PHYSICAL ADDRESS : 424 HENDERSON STREET, PITTSBURG, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BELL 5 CORYELL 3 CONSUMERS ENROLLED STATEWIDE 17 PROVIDER: 8WU WILDA DEAN ODUM ROY Page 31

32 CONTRACT NUMBER : CARING DISABILITY PROVIDER APPLICANT CONTACT: WILDA ROY PHONE: (469) FAX: (972) PHYSICAL ADDRESS : 5044 LAKE VISTA DRIVE, THE COLONY, TX CONSUMERS ENROLLED STATEWIDE 11 PROVIDER: 7CA WILLIAMS CARING HEARTS INC CONTRACT NUMBER : WILLIAMS CARING HEARTS INC APPLICANT CONTACT: DANISHA WILLIAMS PHONE: (832) FAX: (000) PHYSICAL ADDRESS : 8255SUNBURY LANE APT 1006, HOUSTON, TX CONSUMERS ENROLLED STATEWIDE 1 PROVIDER: 77R 1 CARING PROVIDER INC CONTRACT NUMBER : CARING PROVIDER INC INFORMATION PAGE : 42 APPLICANT CONTACT: YOLANDA WHITE PHONE: (817) FAX: (972) PHYSICAL ADDRESS : PRESTON RD; SUITE D9 #321, DALLAS, TX CONSUMERS ENROLLED STATEWIDE 15 PROVIDER: 79G 1 ON 1 KF HOMES, INC. CONTRACT NUMBER : ON 1 KF HOMES, INC. APPLICANT CONTACT: WARREN ANGELA PHONE: (713) FAX: (713) PHYSICAL ADDRESS : 9888 BISSONNET STREET, STE. 350, HOUSTON, TX CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: MCLENNAN 1 CONSUMERS ENROLLED STATEWIDE 166 Page 32

33 PROVIDER: 7C9 1 TRINITY'S PLACE LLC CONTRACT NUMBER : TRINITY'S PLACE LLC APPLICANT CONTACT: LYTRIANA HILL PHONE: (972) FAX: (214) PHYSICAL ADDRESS : 711 CORNERSTONE LANE, DESOTO, TX CONSUMERS ENROLLED STATEWIDE 3 PROVIDER: 8VS 4 CORNERS RESIDENTIAL SERVICES CONTRACT NUMBER : CORNERS RESIDENTIAL CARE, LLC APPLICANT CONTACT: RODERIC HORTON PHONE: (972) FAX: (888) PHYSICAL ADDRESS : NORTH JOSEY LANE STE 204, CARROLLTON, TX CONSUMERS ENROLLED STATEWIDE 10 TOTAL NUMBER OF CONTRACTS THIS MRA: 133 Page 33