MEDICARE: RUTH MARIE'S COUNTRY HOME

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1538304290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUTH MARIE'S COUNTRY HOME

Provider Business Mailing Address
First Line	:	17414 SUGAR PINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2052
Country	:	US
Telephone Number	:	713-822-0826
Fax Number	:

Provider Business Practice Location Address
First Line	:	17414 SUGAR PINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2052
Country	:	US
Telephone Number	:	713-822-0826
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES SIMPSON
Credential	:
Telephone Number	:	713-822-0826

Provider Enumeration Date	:	12/10/2008
Last Update Date	:	12/10/2008

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Directions to “RUTH MARIE'S COUNTRY HOME ” Practice Location

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