Healthcare Provider Details

I. General information

NPI: 1114041811
Provider Name (Legal Business Name): CORPORATE SENIOR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9630 CLAREWOOD DR STE A2
HOUSTON TX
77036-3535
US

IV. Provider business mailing address

9630 CLAREWOOD DR STE A2
HOUSTON TX
77036-3535
US

V. Phone/Fax

Practice location:
  • Phone: 713-777-5123
  • Fax: 713-271-6689
Mailing address:
  • Phone: 713-777-5123
  • Fax: 713-271-6689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number117648
License Number StateTX

VIII. Authorized Official

Name: SUSAN ZHAO
Title or Position: ACTIVITY MANAGER
Credential:
Phone: 281-380-8158