Organization Name: | BERING OMEGA COMMUNITY SERVICES |
NPI Number: | 1114136942 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHEVONNE POTTER (CARE CENTER MANAGER) |
Mailing Address: | 1429 Hawthorne St Houston |
State: | TX US |
Postal Code: | 770063711 |
Phone Number: | 7135296071 |
Fax Number: | 7135293626 |
NPI Enumeration Date: | 05/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 119266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |