MEDICARE: REGENT CARE HOME GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	310400000X	Assisted Living Facility
3	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1952162133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENT CARE HOME GROUP

Provider Business Mailing Address
First Line	:	14800 MEMORIAL DR APT 1215
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-5212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8215 QUAIL HILLS DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5402
Country	:	US
Telephone Number	:	713-581-4802
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JASMINE N RANDOLPH
Credential	:
Telephone Number	:	713-581-4802

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	01/16/2024

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