Provider Demographics
NPI:1154319713
Name:SENIORLIVINGSPROPERTIESLAPORTEHEALTHCARE
Entity Type:Organization
Organization Name:SENIORLIVINGSPROPERTIESLAPORTEHEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-471-1810
Mailing Address - Street 1:208 S UTAH ST
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-5555
Mailing Address - Country:US
Mailing Address - Phone:281-471-1810
Mailing Address - Fax:281-471-8809
Practice Address - Street 1:208 S UTAH ST
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-5555
Practice Address - Country:US
Practice Address - Phone:281-471-1810
Practice Address - Fax:281-471-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility