MEDICARE: HARVEST OF LOVE COMMUNITY SERVICES

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	373H00000X	Day Training/Habilitation Specialist		TX

General Provider Information

NPI Number	:	1396940888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEST OF LOVE COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 38696
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77238-8696
Country	:	US
Telephone Number	:	281-820-2724
Fax Number	:	281-820-2724

Provider Business Practice Location Address
First Line	:	3910 BADGER FOREST DR
Second Line	:	SUITE 2
City	:	HOUSTON
State	:	TX
Zip	:	77088-7417
Country	:	US
Telephone Number	:	281-820-2724
Fax Number	:	281-820-2724

Authorized Official
Title or Position	:	CEO
Name	:	MINNIE HENDERSON
Credential	:
Telephone Number	:	281-820-2724

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	08/22/2020

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