Provider Demographics
NPI:1528324209
Name:BED OF ROSES ASSISTED LIVING LLC
Entity type:Organization
Organization Name:BED OF ROSES ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATER
Authorized Official - Prefix:MR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:NAILS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-635-1475
Mailing Address - Street 1:PO BOX 524101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77052-4101
Mailing Address - Country:US
Mailing Address - Phone:713-635-1475
Mailing Address - Fax:713-635-5463
Practice Address - Street 1:5121 SHREVEPORT BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-3701
Practice Address - Country:US
Practice Address - Phone:713-635-1475
Practice Address - Fax:713-635-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131689310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility