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General NPI Number Information
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NPI Number | 1942559968
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Entity Type | Organization
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Legal Business Name | HELEN'S PEACE HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 6111 KENILWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77033-1223
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Country | US
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Telephone | 832-516-8983
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Fax |
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Provider Business Mailing Address
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Address Line | 6111 KENILWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77033-1223
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Country | US
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Telephone | 832-516-8983
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | MISS DEMETRIA DESHON LUCKETT
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Credential |
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Telephone | 832-516-8983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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