# GENTLE CARE LIVING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** N/A
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124328737
- **Legal business name:** N/A
- **Authorized official:** MS. VANAVIA NAOMI RICHARDSON N/A (DIRECTOR)
- **Authorized official phone:** (832) 775-5203

## Contact information

- **Practice address:** 12660 MEDFIELD DR, STE.418, HOUSTON, TX 77082-5432
- **Practice address phone:** (832) 775-5203
- **Practice address fax:** (832) 775-5204
- **Mailing address:** 2801 WALNUT BEND LN, STE.68, HOUSTON, TX 77042-3464
- **Mailing address phone:** (832) 775-5203
- **Mailing address fax:** (832) 775-5204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 3748 | TX | Yes |

## Other

- **Enumeration date:** 10/28/2010
- **Last updated:** 10/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 029093410 | — | TX |
| 05 | — | 189407301 | — | TX |
| 05 | — | 205602001 | — | TX |