MEDICARE: CHERRIE FOX

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	310400000X	Assisted Living Facility
2	3104A0625X	Assisted Living Facility (Mental Illness)
3	3104A0630X	Assisted Living Facility (Behavioral Disturbances)

General Provider Information

NPI Number	:	1306078340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERRIE FOX

Provider Business Mailing Address
First Line	:	3403 GREEN ASPEN LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-4578
Country	:	US
Telephone Number	:	713-259-0559
Fax Number	:	713-434-8544

Provider Business Practice Location Address
First Line	:	3403 GREEN ASPEN LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-4578
Country	:	US
Telephone Number	:	713-259-0559
Fax Number	:	713-434-8544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2009
Last Update Date	:	08/09/2009

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Directions to “ CHERRIE FOX ” Practice Location

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