MEDICARE: A & M SENIOR VILLAGE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063575348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & M SENIOR VILLAGE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 451533
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77245-1533
Country	:	US
Telephone Number	:	713-433-7317
Fax Number	:	713-413-1242

Provider Business Practice Location Address
First Line	:	3917 ANDERSON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-2407
Country	:	US
Telephone Number	:	713-433-7317
Fax Number	:	713-413-1242

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. A. R. MORRISON
Credential	:
Telephone Number	:	713-433-7317

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	06/03/2008

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