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General NPI Number Information
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NPI Number | 1528353935
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Entity Type | Organization
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Legal Business Name | 1212 SENIOR CARE, INC.
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 4200 WESTHEIMER RD SUITE 186
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City | HOUSTON
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State | TX
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Zip | 77027-4415
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Country | US
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Telephone | 713-403-2273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84290
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City | PEARLAND
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State | TX
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Zip | 77584-0016
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Country | US
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Telephone | 281-386-8192
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS HAROLD RAY CORKRAN
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Credential |
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Telephone | 281-386-8192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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