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General NPI Number Information
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NPI Number | 1639205669
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Entity Type | Organization
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Legal Business Name | BRETT DANIEL SCALLY
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 20219 AMBERLIGHT LN
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City | KATY
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State | TX
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Zip | 77450-5077
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Country | US
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Telephone | 281-398-5020
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Fax | 281-578-5436
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Provider Business Mailing Address
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Address Line | 20219 AMBERLIGHT LN
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City | KATY
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State | TX
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Zip | 77450-5077
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Country | US
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Telephone | 281-398-5020
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Fax | 281-578-5436
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. SUZANNE SCALLY
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Credential | R.N.
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Telephone | 281-398-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010408
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License Number State | TX
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