Organization
SENIOR CITIZENS BUREAU
Active
Other names
VaughnGage Healthy Aging Center
Organization subpart
No
Provider details
NPI number
Authorized official
ASHEVA PHILLIPS (CEO)
(832) 478-9333
Entity
Organization
Contact information
Practice address
9406 FERN WOOD FRST, HOUSTON, TX 77040-6892
(713) 291-1567
Mailing address
9406 FERN WOOD FRST, HOUSTON, TX 77040-6892
(713) 291-1567
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
143030
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143030
DADS LICENSE
TX
Enumeration date
10/12/2015
Last updated
04/13/2016
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