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General NPI Number Information
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NPI Number | 1083096333
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Entity Type | Organization
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Legal Business Name | MORNINGGLORY SENIOR CARE HAVEN
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 6218 CANYON TRACE CT
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City | KATY
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State | TX
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Zip | 77450-7099
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Country | US
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Telephone | 281-734-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 6218 CANYON TRACE CT
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City | KATY
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State | TX
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Zip | 77450-7099
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Country | US
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Telephone | 281-734-2211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MANUEL V SANCHEZ JR.
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Credential |
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Telephone | 271-734-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number | 05517643
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License Number State | TX
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