1619242716 NPI number — HEAVENLY HANDS CHILDREN'S MEDICAL DAYCARE CENTER

Table of content: (NPI 1619242716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619242716 NPI number — HEAVENLY HANDS CHILDREN'S MEDICAL DAYCARE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEAVENLY HANDS CHILDREN'S MEDICAL DAYCARE CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PRESCRIBED PEDIATRIC EXTENDED CARE CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619242716
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8002 WEST AVE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
CASTLE HILLS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78213-1865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-560-3938
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8002 WEST AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CASTLE HILLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78213-1865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-560-3938
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
CARNELL
Authorized Official Title or Position:
CEO/FOUNDER
Authorized Official Telephone Number:
210-363-3269

Provider Taxonomy Codes

  • Taxonomy code: 385HR2060X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385HR2065X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com