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HEAVENLY MANOR ASSISTED LIVING LLC NPI 1811518863


NPI Information

NPI: 1811518863
Provider Name: HEAVENLY MANOR ASSISTED LIVING LLC

Doing Business As: HEAVENLY MANOR ASSISTED LIVING

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
12802 LEITRIM WAY
HOUSTON, TX
ZIP 77047
Phone: (281) 846-6622
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HEAVENLY MANOR ASSISTED LIVING LLC is an assisted living facility in Houston, TX. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. HEAVENLY MANOR ASSISTED LIVING LLC NPI is 1811518863. The provider is registered as an organization entity type.
The provider Is Doing Business As Heavenly Manor Assisted Living.

The provider's business location address is:

12802 LEITRIM WAY
HOUSTON, TX
ZIP 77047-726
Phone: (281) 846-6622
Fax: (713) 264-0802

The provider's authorized official is Mia Singleton .
The authorized official title is Administrator/owner and has the following contact phone number (713) 359-8273.

The enumeration date for this NPI number is 4/30/2020 and was last updated on 5/6/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
112802MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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