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General NPI Number Information
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NPI Number | 1871786400
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Entity Type | Organization
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Legal Business Name | MOTHERS LOVE
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 3203 SANTANA DR
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City | PORTER
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State | TX
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Zip | 77365-8525
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Country | US
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Telephone | 713-419-8085
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Fax | 281-354-7706
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Provider Business Mailing Address
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Address Line | 3203 SANTANA DR
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City | PORTER
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State | TX
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Zip | 77365-8525
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Country | US
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Telephone | 713-419-8085
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Fax | 281-354-7706
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Authorized Official
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Title or Position | OWNER/CREATOR
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Name | MRS. JEANEANNE E RAY
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Credential | L.V.N.
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Telephone | 713-419-8085
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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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