Provider Demographics
NPI:1083096333
Name:MORNINGGLORY SENIOR CARE HAVEN
Entity Type:Organization
Organization Name:MORNINGGLORY SENIOR CARE HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:271-734-2211
Mailing Address - Street 1:6218 CANYON TRACE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7099
Mailing Address - Country:US
Mailing Address - Phone:281-734-2211
Mailing Address - Fax:
Practice Address - Street 1:6218 CANYON TRACE CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7099
Practice Address - Country:US
Practice Address - Phone:281-734-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05517643385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp