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General NPI Number Information
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NPI Number | 1104408301
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Entity Type | Organization
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Legal Business Name | CASCADES AT JACINTO REHAB, LP
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 1405 HOLLAND ST
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City | HOUSTON
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State | TX
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Zip | 77029-2845
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Country | US
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Telephone | 713-455-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 5314 RIVER RUN DR STE 140
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City | PROVO
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State | UT
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Zip | 84604-7706
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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 | MANAGER
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Name | DARIN MCSPADDEN
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Credential |
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Telephone | 801-494-0487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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