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General NPI Number Information
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NPI Number | 1891328746
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Entity Type | Organization
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Legal Business Name | GOLDEN MOMENTS HOSPICE, LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 650 N SAM HOUSTON PKWY E STE 210
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City | HOUSTON
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State | TX
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Zip | 77060-5908
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Country | US
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Telephone | 832-312-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 650 N SAM HOUSTON PKWY E STE 210
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City | HOUSTON
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State | TX
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Zip | 77060-5908
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Country | US
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Telephone | 832-312-7660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TATYANA MANAGO GRAVES
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Credential |
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Telephone | 832-229-5248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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