MEDICARE: ST MICHAELS HOSPITAL & HEALTHCARE GROUP 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	282E00000X	Long Term Care Hospital	100048	TX

General Provider Information

NPI Number	:	1215252317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST MICHAELS HOSPITAL & HEALTHCARE GROUP LLC

Provider Business Mailing Address
First Line	:	2310 ELDRIDGE PKWY S
Second Line	:	STE 100
City	:	HOUSTON
State	:	TX
Zip	:	77077-5254
Country	:	US
Telephone Number	:	281-392-5700
Fax Number	:	281-392-5795

Provider Business Practice Location Address
First Line	:	2310 ELDRIDGE PKWY S
Second Line	:	STE 100
City	:	HOUSTON
State	:	TX
Zip	:	77077-5254
Country	:	US
Telephone Number	:	281-392-5700
Fax Number	:	281-392-5795

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	GARY TOCHE
Credential	:
Telephone Number	:	281-392-5700

Provider Enumeration Date	:	03/31/2010
Last Update Date	:	05/19/2011

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