S & G Community Living Center, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

117286 Issued in TX

Legal business name

S & G COMMUNITY LIVING CENTER, INC.

Doing business as

Pebbleshire House

Practice address

7865 Pecan Villas
Houston, TX 77061

Phone

(713) 598-1471

Fax

(281) 334-7850

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steve Alan Mulkey, QMRP

Title

President

Phone

(713) 598-1471

Specialties & licenses 2

Addresses

Other names 1

• Pebbleshire House Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1063624237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 686",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "77574",
            "telephone_number": "713-598-1471",
            "fax_number": "281-334-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7865 PECAN VILLAS",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77061",
            "telephone_number": "713-598-1471",
            "fax_number": "281-334-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S & G COMMUNITY LIVING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "MULKEY",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-598-1471",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QMRP"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "117286",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pebbleshire House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual Disabilities Intermediate Care Facility in Houston, TX
• Providers in Houston, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.