Provider Demographics
NPI:1124205968
Name:MEMORIAL HERMANN AFFILIATED SERVICES
Entity Type:Organization
Organization Name:MEMORIAL HERMANN AFFILIATED SERVICES
Other - Org Name:UNIVERSITY PLACE RETIREMENT COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DOLLAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-2900
Mailing Address - Street 1:7480 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4539
Mailing Address - Country:US
Mailing Address - Phone:713-541-2900
Mailing Address - Fax:
Practice Address - Street 1:7480 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4539
Practice Address - Country:US
Practice Address - Phone:713-541-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home