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General NPI Number Information
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NPI Number | 1104170562
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Entity Type | Organization
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Legal Business Name | PREMIER ASSISTED LIVING HOMES # 2
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 10607 RAYDELL DR
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City | HOUSTON
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State | TX
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Zip | 77031-1807
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Country | US
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Telephone | 281-827-1477
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Fax | 281-530-6266
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Provider Business Mailing Address
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Address Line | 9135 RENTUR DR
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City | HOUSTON
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State | TX
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Zip | 77031-1125
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Country | US
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Telephone | 713-988-1266
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Fax | 713-988-1660
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SAMUEL ONWUHARONYE
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Credential |
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Telephone | 281-827-1477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 131312
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License Number State | TX
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