Healthcare Provider Details

I. General information

NPI: 1831623818
Provider Name (Legal Business Name): VILLAGE ON SHEPHERD AT RIVER OAKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S SHEPHERD DR
HOUSTON TX
77019
US

IV. Provider business mailing address

6363 WOODWAY DR SUITE 410
HOUSTON TX
77057
US

V. Phone/Fax

Practice location:
  • Phone: 713-952-7600
  • Fax:
Mailing address:
  • Phone: 281-996-0101
  • Fax: 281-996-1141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DIANN MARIE DIFRANCESCO
Title or Position: SR. V.P. OF OPERATIONS
Credential:
Phone: 281-996-0101