Marigold Cottagepch@Waller LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

126128 Issued in TX

Legal business name

MARIGOLD COTTAGEPCH@WALLER LLC

Practice address

1802 Mallard Dr
Houston, TX 77043-2915

Phone

(713) 468-8059

Fax

(713) 721-0226

NPI assigned

May 27, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Annie Hivale

Title

Owner/Manager

Phone

(713) 468-8059

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1962637595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10222 SHADOW WOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770432938",
            "telephone_number": "713-468-8059",
            "fax_number": "713-721-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 MALLARD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770432915",
            "telephone_number": "713-468-8059",
            "fax_number": "713-721-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIGOLD COTTAGEPCH@WALLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "HIVALE",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "713-468-8059",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "126128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Marin Costa, MD
• Maria Patricia Marin Tobon

• 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 27, 2009; 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.