Healthcare Provider Details

I. General information

NPI: 1063285930
Provider Name (Legal Business Name): TENDER HEARTS ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 TALLOW DR
CONROE TX
77385-9533
US

IV. Provider business mailing address

PO BOX 280338
HOUSTON TX
77228-0338
US

V. Phone/Fax

Practice location:
  • Phone: 281-296-8825
  • Fax: 281-296-0066
Mailing address:
  • Phone: 281-296-8825
  • Fax: 281-296-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHAKETTA GUILLORY - PRESTON
Title or Position: OWNER/MANAGER
Credential:
Phone: 281-296-8825