MEDICARE: SPRING BRANCH CARE HOMES, 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	310400000X	Assisted Living Facility	010372	TX

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	:	1144422320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING BRANCH CARE HOMES, INC

Provider Business Mailing Address
First Line	:	4630 HUDSON RD.
Second Line	:
City	:	SANTA FE
State	:	TX
Zip	:	77517
Country	:	US
Telephone Number	:	713-467-4444
Fax Number	:	409-938-0258

Provider Business Practice Location Address
First Line	:	9619 TRUSCON DRIVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5601
Country	:	US
Telephone Number	:	713-467-4444
Fax Number	:

Authorized Official
Title or Position	:	ADM/SEC/TREAS
Name	:	CINDY GOLIAN
Credential	:	RCP
Telephone Number	:	713-467-4444

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	04/03/2020

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