1730307497 NPI number — LOVE & JOY PERSONAL CARE HOME

Table of content: (NPI 1730307497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730307497 NPI number — LOVE & JOY PERSONAL CARE HOME

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOVE & JOY PERSONAL CARE HOME
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:
LOVE AND JOY REHAB ADULT DAY CARE
Provider Other Organization Name Type Code:
3
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:
1730307497
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 330344
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77233-0344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-684-1641
Provider Business Mailing Address Fax Number:
713-733-3695

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4440 BENNINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77016-6904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-733-6900
Provider Business Practice Location Address Fax Number:
713-738-8323
Provider Enumeration Date:
04/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SWIRCZYNSKI
Authorized Official First Name:
SHEILA
Authorized Official Middle Name:
EVETTE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
713-733-6900

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  120204 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: 005453 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , with the licence number: 119797 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , with the licence number: 115409 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , with the licence number: 119594 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , with the licence number: 119122 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X , with the licence number: 0001007280 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 005453 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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