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General NPI Number Information
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NPI Number | 1093427577
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Entity Type | Organization
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Legal Business Name | MALONEGROVE FAMILY CARE & REHABILITATION LLC
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 3305 NORTH ST
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City | NACOGDOCHES
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State | TX
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Zip | 75965-2690
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Country | US
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Telephone | 832-661-7501
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Fax |
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Provider Business Mailing Address
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Address Line | 6502 CENTRE PLACE CIR
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City | SPRING
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State | TX
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Zip | 77379-2937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHEIF OPERATIONS OFFICER
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Name | APRIL HENRY
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Credential |
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Telephone | 832-661-7501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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