Provider Demographics
NPI:1255873907
Name:LADYBIRDS SENIOR CARE HOME LLC
Entity type:Organization
Organization Name:LADYBIRDS SENIOR CARE HOME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-407-0605
Mailing Address - Street 1:5827 KNOLLWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-4986
Mailing Address - Country:US
Mailing Address - Phone:713-269-9235
Mailing Address - Fax:866-423-3747
Practice Address - Street 1:4810 AQUAGATE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-4943
Practice Address - Country:US
Practice Address - Phone:713-269-9235
Practice Address - Fax:866-423-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-11
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)