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NPI Code Detail

MEDICARE: FRIENDSHIP HAVEN NURSING CENTERS LTD

MEDICARE: FRIENDSHIP HAVEN NURSING CENTERS LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility110078TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HH081SOTHERTXBLUE CROSS/BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609879402
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRIENDSHIP HAVEN NURSING CENTERS LTD
Provider Business Mailing Address
First Line : 1500 SUNSET DR
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4724
Country : US
Telephone Number : 281-992-4300
Fax Number : 281-992-0816
Provider Business Practice Location Address
First Line : 1500 SUNSET DR
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-4724
Country : US
Telephone Number : 281-992-4300
Fax Number : 281-992-0816
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. RALEIGH LEE
Credential :
Telephone Number : 281-992-4300
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/28/2008

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Directions to “FRIENDSHIP HAVEN NURSING CENTERS LTD ” Practice Location

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