Healthcare Provider Details

I. General information

NPI: 1750869723
Provider Name (Legal Business Name): MORNING GLORY RESIDENTIAL LIVING AND HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 GOLDEN EAGLE ST
PFLUGERVILLE TX
78660-5804
US

IV. Provider business mailing address

1205 GOLDEN EAGLE ST
PFLUGERVILLE TX
78660-5804
US

V. Phone/Fax

Practice location:
  • Phone: 512-669-3225
  • Fax:
Mailing address:
  • Phone: 512-669-3225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JANE TAYLOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 512-669-3225