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NPI Code Detail

MEDICARE: GREENWAY MANOR PERSONAL CARE HOME

MEDICARE: GREENWAY MANOR PERSONAL CARE 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
1320800000XMental Illness Community Based Residential Treatment Facility119109TX

General Provider Information

NPI Number : 1841329190
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREENWAY MANOR PERSONAL CARE HOME
Provider Business Mailing Address
First Line : PO BOX 11700
Second Line :
City : HOUSTON
State : TX
Zip : 77293-1700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3625 HOPPER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77093-2719
Country : US
Telephone Number : 281-987-3767
Fax Number : 281-987-0702
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. VIRGINIA W BAKER
Credential : PROVIDER
Telephone Number : 281-987-3767
Provider Enumeration Date : 03/05/2007
Last Update Date : 08/22/2020

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Directions to “GREENWAY MANOR PERSONAL CARE HOME ” Practice Location

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