Healthcare Provider Details

I. General information

NPI: 1003657487
Provider Name (Legal Business Name): HARMONIOUS LIVING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 WINDHAM WAY
KATY TX
77494-6346
US

IV. Provider business mailing address

3419 WINDHAM WAY
KATY TX
77494-6346
US

V. Phone/Fax

Practice location:
  • Phone: 281-934-5088
  • Fax:
Mailing address:
  • Phone: 313-283-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEREE SLACK
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 313-283-2118