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Organization subpart
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Provider details

NPI number
Authorized official
MRS. KIMBERLY M SILLS (FACILITY DIRECTOR)
(281) 770-3751
Entity
Organization

Contact information

Practice address
13820 EAGLE PASS ST, HOUSTON, TX 77015-3916
(281) 770-3751
Mailing address
10911 CORNWALL LN, MISSOURI CITY, TX 77459-3374
(281) 770-3751

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
311500000X
Alzheimer Center (Dementia Center)
311ZA0620X
Adult Care Home Facility
320700000X
Physical Disabilities Residential Treatment Facility

Other

Enumeration date
12/14/2007
Last updated
12/14/2007
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