Provider Demographics
NPI:1720350523
Name:REMINGTON GROVE GROUP HOME
Entity type:Organization
Organization Name:REMINGTON GROVE GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RAECHELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIS-SANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-569-3231
Mailing Address - Street 1:7438 LEGACY PINES DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2125
Mailing Address - Country:US
Mailing Address - Phone:985-634-9703
Mailing Address - Fax:
Practice Address - Street 1:7438 LEGACY PINES DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2125
Practice Address - Country:US
Practice Address - Phone:985-634-9703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based