Heavenly Manor Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HEAVENLY MANOR ASSISTED LIVING LLC

Practice address

12802 Leitrim Way
Houston, TX 77047-3726

Phone

(281) 846-6622

Fax

(713) 264-0802

NPI assigned

Apr 30, 2020

Organization subpart

No

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

Authorized official

Name

Mia Singleton

Title

Administrator/Owner

Phone

(713) 359-8273

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heavenly Manor Assisted Living Doing business as

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1811518863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12802 LEITRIM WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770473726",
            "telephone_number": "281-846-6622",
            "fax_number": "713-264-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12802 LEITRIM WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770473726",
            "telephone_number": "281-846-6622",
            "fax_number": "713-264-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY MANOR ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-30",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "MIA",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "713-359-8273"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heavenly Manor Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heavenly Manor Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Houston, TX
• Providers in Houston, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.