MEDICARE: HOUSE OF HOPE II

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	107139	TX

General Provider Information

NPI Number	:	1467699223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSE OF HOPE II

Provider Business Mailing Address
First Line	:	PO BOX 331353
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77233-1353
Country	:	US
Telephone Number	:	832-814-4195
Fax Number	:

Provider Business Practice Location Address
First Line	:	4610 MCKINNEY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77023-1228
Country	:	US
Telephone Number	:	832-814-4195
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRY D WALKER
Credential	:
Telephone Number	:	832-814-4195

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	01/15/2009

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