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General NPI Number Information
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NPI Number | 1790138154
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Entity Type | Organization
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Legal Business Name | HOME SWEET HOME ASSISTED LIVING
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 155 COUNTY ROAD 6721
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City | NATALIA
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State | TX
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Zip | 78059-2123
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Country | US
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Telephone | 210-618-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 155 COUNTY ROAD 6721
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City | NATALIA
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State | TX
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Zip | 78059-2123
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Country | US
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Telephone | 210-618-9758
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS SAIDA SHELLHOUSE
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Credential |
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Telephone | 210-618-9758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | TX
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