Organization Name: | BETHSEDA ASSISTED LIVING FACILITY |
NPI Number: | 1073946752 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEWIS CHARLES (OWNER/ADMINISTRATOR) |
Mailing Address: | 7315 Towerview Ln Missouri City |
State: | TX US |
Postal Code: | 774892433 |
Phone Number: | 2814372956 |
Fax Number: | 2812618173 |
NPI Enumeration Date: | 08/16/2013 |
NPI Last Update Date: | 08/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | 101677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |