Provider Demographics
NPI:1952732711
Name:KATHLEEN MOSBY
Entity Type:Organization
Organization Name:KATHLEEN MOSBY
Other - Org Name:ANGEL OF LOVE PERSONAL CARE HOME, TAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-635-3700
Mailing Address - Street 1:PO BOX 62262
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77205-2262
Mailing Address - Country:US
Mailing Address - Phone:713-933-4862
Mailing Address - Fax:
Practice Address - Street 1:7634 CABOT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-3918
Practice Address - Country:US
Practice Address - Phone:713-491-9582
Practice Address - Fax:281-492-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134383310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility