Provider Demographics
NPI:1346710092
Name:HOUSTON SENIOR CARE ANGELS
Entity Type:Organization
Organization Name:HOUSTON SENIOR CARE ANGELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:ATHANAS
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:713-459-8567
Mailing Address - Street 1:13003 ELMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2062
Mailing Address - Country:US
Mailing Address - Phone:713-459-8567
Mailing Address - Fax:
Practice Address - Street 1:13003 ELMINGTON DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2062
Practice Address - Country:US
Practice Address - Phone:713-459-8567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty