Provider Demographics
NPI:1073948329
Name:GOOD OLD DAYS ADULT DAYCARE LLC
Entity Type:Organization
Organization Name:GOOD OLD DAYS ADULT DAYCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELL, LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-227-0404
Mailing Address - Street 1:5339 EASTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039
Mailing Address - Country:US
Mailing Address - Phone:281-227-0404
Mailing Address - Fax:832-408-7607
Practice Address - Street 1:5339 EASTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039
Practice Address - Country:US
Practice Address - Phone:281-227-0404
Practice Address - Fax:832-408-7607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF500300630Medicaid