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NPI Code Detail

MEDICARE: PARK PLACE HCS

MEDICARE: PARK PLACE HCS
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1982985560
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARK PLACE HCS
Provider Business Mailing Address
First Line : 12802 SCHILLER PARK LN
Second Line :
City : HOUSTON
State : TX
Zip : 77014-1953
Country : US
Telephone Number : 832-472-4488
Fax Number :
Provider Business Practice Location Address
First Line : 12802 SCHILLER PARK LN
Second Line :
City : HOUSTON
State : TX
Zip : 77014-1953
Country : US
Telephone Number : 832-472-4488
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHALLA DENINE PARKER
Credential :
Telephone Number : 832-472-4488
Provider Enumeration Date : 09/08/2011
Last Update Date : 09/08/2011

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Directions to “PARK PLACE HCS ” Practice Location

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