Organization
CORPORATE SENIOR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN ZHAO (ACTIVITY MANAGER)
(281) 380-8158
Entity
Organization
Contact information
Practice address
9630 CLAREWOOD DR STE A2, HOUSTON, TX 77036-3535
(713) 777-5123
(713) 271-6689
Mailing address
9630 CLAREWOOD DR STE A2, HOUSTON, TX 77036-3535
(713) 777-5123
(713) 271-6689
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
117648
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014978
AMERIGROUP ID
TX
Enumeration date
03/19/2007
Last updated
03/16/2021
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