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General NPI Number Information
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NPI Number | 1063285930
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Entity Type | Organization
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Legal Business Name | TENDER HEARTS ASSISTED LIVING
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 327 TALLOW DR
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City | CONROE
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State | TX
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Zip | 77385-9533
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Country | US
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Telephone | 281-296-8825
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Fax | 281-296-0066
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Provider Business Mailing Address
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Address Line | PO BOX 280338
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City | HOUSTON
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State | TX
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Zip | 77228-0338
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Country | US
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Telephone | 281-296-8825
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Fax | 281-296-0066
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. SHAKETTA GUILLORY - PRESTON
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Credential |
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Telephone | 281-296-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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