Provider Demographics
NPI:1407178569
Name:EASTFIELD MEADOW
Entity Type:Organization
Organization Name:EASTFIELD MEADOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DEBBIE
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-890-5282
Mailing Address - Street 1:2015 EASTFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3611
Mailing Address - Country:US
Mailing Address - Phone:832-890-5282
Mailing Address - Fax:281-438-5629
Practice Address - Street 1:2015 EASTFIELD CIR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3611
Practice Address - Country:US
Practice Address - Phone:832-890-5282
Practice Address - Fax:281-438-5629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532493310400000X, 3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness