Provider Demographics
NPI:1003657487
Name:HARMONIOUS LIVING HOME
Entity type:Organization
Organization Name:HARMONIOUS LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:313-283-2118
Mailing Address - Street 1:3419 WINDHAM WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6346
Mailing Address - Country:US
Mailing Address - Phone:313-283-2118
Mailing Address - Fax:
Practice Address - Street 1:3419 WINDHAM WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6346
Practice Address - Country:US
Practice Address - Phone:281-934-5088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-01
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility