Gina Assisted Living

NPI #1104591478 in Fulshear, Texas

Provider Information

NPI Number: 1104591478
Entity Type: Organization
Organization Name: Gina Assisted Living
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Aug 10, 2021
Last Updated: Aug 10, 2021

Practice Location

Address: 28418 ENCHANTED SHORES LN
City: Fulshear
State: Texas
ZIP Code: 77441-1791
Phone: (832) 494-0623

Authorized Official

Name: REGINA E BESONG
Title: PROGRAM MANAGER
Phone: (832) 494-0623

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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