Provider Demographics
NPI:1972357598
Name:SOUTHPOINT ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:SOUTHPOINT ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOVIRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-407-0543
Mailing Address - Street 1:1501 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3722
Mailing Address - Country:US
Mailing Address - Phone:281-407-0543
Mailing Address - Fax:
Practice Address - Street 1:1501 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3722
Practice Address - Country:US
Practice Address - Phone:281-407-0543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility