Provider Demographics
NPI:1285626028
Name:TRIUMPH HOSPITAL OF NORTH HOUSTON, LP
Entity Type:Organization
Organization Name:TRIUMPH HOSPITAL OF NORTH HOUSTON, LP
Other - Org Name:KINDRED HOSPITAL SPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:K-LIVE 5 REIMBURSEMENT
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:502-596-7300
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:205 HOLLOW TREE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2801
Practice Address - Country:US
Practice Address - Phone:832-249-2700
Practice Address - Fax:281-255-2954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007134282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094354003Medicaid
TXHH1003OtherBCBS
TX094354003Medicaid