Healthcare Provider Details

I. General information

NPI: 1396940888
Provider Name (Legal Business Name): HARVEST OF LOVE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 BADGER FOREST DR SUITE 2
HOUSTON TX
77088-7417
US

IV. Provider business mailing address

PO BOX 38696
HOUSTON TX
77238-8696
US

V. Phone/Fax

Practice location:
  • Phone: 281-820-2724
  • Fax: 281-820-2724
Mailing address:
  • Phone: 281-820-2724
  • Fax: 281-820-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateTX

VIII. Authorized Official

Name: MINNIE HENDERSON
Title or Position: CEO
Credential:
Phone: 281-820-2724