MEDICARE: ANIEVES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1174852339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANIEVES CORPORATION

Provider Business Mailing Address
First Line	:	2510 BROAD ST
Second Line	:	SUITE 201
City	:	HOUSTON
State	:	TX
Zip	:	77087-1445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2510 BROAD ST
Second Line	:	SUITE 201
City	:	HOUSTON
State	:	TX
Zip	:	77087-1445
Country	:	US
Telephone Number	:	832-721-7470
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CARMEL O'REARDON
Credential	:	LCSW
Telephone Number	:	832-721-7470

Provider Enumeration Date	:	12/17/2009
Last Update Date	:	12/17/2009

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Directions to “ANIEVES CORPORATION ” Practice Location

Language	Start Address	Practice Location

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