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General NPI Number Information
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NPI Number | 1356356935
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Entity Type | Organization
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Legal Business Name | IHS ACQUISITION NO 136 INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 12350 WOOD BAYOU DR
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City | HOUSTON
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State | TX
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Zip | 77013-4930
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Country | US
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Telephone | 713-453-0446
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Fax | 713-450-3073
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Provider Business Mailing Address
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Address Line | 12350 WOOD BAYOU DR
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City | HOUSTON
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State | TX
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Zip | 77013-4930
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Country | US
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Telephone | 713-453-0446
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Fax | 713-450-3073
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Authorized Official
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Title or Position | CFO
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Name | MR. TIMOTHY J TRYBUS
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Credential |
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Telephone | 443-539-2354
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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 | 1129213
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License Number State | TX
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