| NPI | 1912997222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY WILLIAMS President 281-574-7495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 117214) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 117214) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 117214) | |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies (Licence: TX 117214) | |
| 385H00000X Respite Care (Licence: TX 117214) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2012-07-06 |