Provider Demographics
NPI:1063220622
Name:TUSCANY LIVING VILLA AT WICKERSHAM
Entity type:Organization
Organization Name:TUSCANY LIVING VILLA AT WICKERSHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANI
Authorized Official - Middle Name:CABRAL
Authorized Official - Last Name:PASAO
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:832-276-3033
Mailing Address - Street 1:11019 WICKERSHAM LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-2717
Mailing Address - Country:US
Mailing Address - Phone:832-581-3765
Mailing Address - Fax:832-327-8708
Practice Address - Street 1:11019 WICKERSHAM LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2717
Practice Address - Country:US
Practice Address - Phone:832-581-3765
Practice Address - Fax:832-327-8708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty