Healthcare Provider Details

I. General information

NPI: 1619242716
Provider Name (Legal Business Name): HEAVENLY HANDS CHILDREN'S MEDICAL DAYCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 WEST AVE SUITE 1
CASTLE HILLS TX
78213-1865
US

IV. Provider business mailing address

8002 WEST AVE SUITE 1
CASTLE HILLS TX
78213-1865
US

V. Phone/Fax

Practice location:
  • Phone: 210-560-3938
  • Fax:
Mailing address:
  • Phone: 210-560-3938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. SEAN CARNELL SCOTT
Title or Position: CEO/FOUNDER
Credential:
Phone: 210-363-3269