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General NPI Number Information
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NPI Number | 1700622552
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Entity Type | Organization
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Legal Business Name | GOLDEN HARVEST HOMES LLC
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 11 LITTLE SORRELL CT
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City | TOMBALL
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State | TX
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Zip | 77377-2627
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Country | US
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Telephone | 832-483-2875
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Fax |
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Provider Business Mailing Address
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Address Line | 11 LITTLE SORRELL CT
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City | TOMBALL
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State | TX
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Zip | 77377-2627
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Country | US
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Telephone | 832-483-2875
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LASHANDRA MICHELLE CHELLAM
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Credential |
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Telephone | 832-483-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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