Healthcare Provider Details

I. General information

NPI: 1003077967
Provider Name (Legal Business Name): COMMUNITY HEALTH RESOURCE GROUP, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8202 KNURLED OAK LN
SPRING TX
77379-3963
US

IV. Provider business mailing address

8202 KNURLED OAK LN
SPRING TX
77379-3963
US

V. Phone/Fax

Practice location:
  • Phone: 281-251-4979
  • Fax: 281-655-5015
Mailing address:
  • Phone: 281-251-4979
  • Fax: 281-655-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number608309
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL S. PITTS
Title or Position: ADMINISTRATOR
Credential: RN,BSN
Phone: 281-251-4979