| Stonebridge Structured Independent Living, Inc | |
|
5303 Pebble Springs Dr Houston TX 77066-2542 | |
| (832) 326-5000 | |
| (888) 315-2272 |
| Full Name | Stonebridge Structured Independent Living, Inc |
|---|---|
| Speciality | Custodial Care Facility |
| Location | 5303 Pebble Springs Dr, Houston, Texas |
| Authorized Official Name and Position | Rebeccah Walker (DIRECTOR) |
| Authorized Official Contact | 8323265000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonebridge Structured Independent Living, Inc Po Box 692368 Houston TX 77269-2368 Ph: () - | Stonebridge Structured Independent Living, Inc 5303 Pebble Springs Dr Houston TX 77066-2542 Ph: (832) 326-5000 |
| NPI Number | 1205016128 |
|---|---|
| Provider Enumeration Date | 11/08/2007 |
| Last Update Date | 02/14/2017 |
| Medicare PECOS PAC ID | 9739455718 |
|---|---|
| Medicare Enrollment ID | O20171018002284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205016128 | NPI | - | NPPES |
| Provider Name | Clotie L Wayland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174702302 PECOS PAC ID: 6507829561 Enrollment ID: I20050622000233 |
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