Healthcare Provider Details

I. General information

NPI: 1083803175
Provider Name (Legal Business Name): ALL ABOUT SENIORS ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 WEST 34 STE C-54
HOUSTON TX
77092-5719
US

IV. Provider business mailing address

4800 W 34TH ST STE C54
HOUSTON TX
77092-6659
US

V. Phone/Fax

Practice location:
  • Phone: 713-812-8998
  • Fax: 713-812-8999
Mailing address:
  • Phone: 713-812-8998
  • Fax: 713-812-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number119239
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number119239
License Number StateTX

VIII. Authorized Official

Name: MRS. DORIS N HARRIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 713-812-8998