Provider Demographics
NPI:1063285930
Name:TENDER HEARTS ASSISTED LIVING
Entity type:Organization
Organization Name:TENDER HEARTS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLORY - PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-296-8825
Mailing Address - Street 1:PO BOX 280338
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77228-0338
Mailing Address - Country:US
Mailing Address - Phone:281-296-8825
Mailing Address - Fax:281-296-0066
Practice Address - Street 1:327 TALLOW DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-9533
Practice Address - Country:US
Practice Address - Phone:281-296-8825
Practice Address - Fax:281-296-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances