Healthcare Provider Details

I. General information

NPI: 1750535068
Provider Name (Legal Business Name): GOLDEN MEADOWS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 TIDEWATER DR
HOUSTON TX
77045-4343
US

IV. Provider business mailing address

4411 TIDEWATER DR
HOUSTON TX
77045-4343
US

V. Phone/Fax

Practice location:
  • Phone: 713-433-8880
  • Fax:
Mailing address:
  • Phone: 713-433-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number000967
License Number StateTX

VIII. Authorized Official

Name: MR. WILLIAM T RHODES
Title or Position: OWNER
Credential:
Phone: 713-433-8880