Healthcare Provider Details

I. General information

NPI: 1518687375
Provider Name (Legal Business Name): FAITH & MEMORIAL NURSING & REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 GARNER RD
PASADENA TX
77502-2315
US

IV. Provider business mailing address

7358 N LINCOLN AVE
LINCOLNWOOD IL
60712-1710
US

V. Phone/Fax

Practice location:
  • Phone: 713-473-8573
  • Fax:
Mailing address:
  • Phone: 602-882-1273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AHARON SHKOP
Title or Position: MANAGER
Credential:
Phone: 847-450-1425