MEDICARE: HELPING HOMES ASSISTED LIVING LLC

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	3104A0625X	Assisted Living Facility (Mental Illness)

General Provider Information

NPI Number	:	1174815112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING HOMES ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	10902 FULLERTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043
Country	:	US
Telephone Number	:	832-247-6824
Fax Number	:

Provider Business Practice Location Address
First Line	:	10902 FULLERTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-1908
Country	:	US
Telephone Number	:	832-247-6824
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. TONY T NGUYEN
Credential	:
Telephone Number	:	832-247-6824

Provider Enumeration Date	:	05/10/2011
Last Update Date	:	05/12/2011

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