Organization
SR GOLDEN HEART PROVIDER CARE AND TRANSPORTATION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEVAO FAYIA SAFFA (PROGRAM MANAGER)
(713) 784-2480
Entity
Organization
Contact information
Practice address
7100 REGENCY SQUARE BLVD, SUITE 203-5, HOUSTON, TX 77036-3202
(713) 784-2480
(713) 784-2860
Mailing address
7100 REGENCY SQUARE BLVD, SUITE 203-5, HOUSTON, TX 77036-3202
(713) 784-2480
(713) 784-2860
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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