MEDICARE: TOTAL HEALTH & CONSULTING, LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1588162598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HEALTH & CONSULTING, LLC

Provider Business Mailing Address
First Line	:	2331 ALASSIO ISLE CT
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6977
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 ALASSIO ISLE CT
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6977
Country	:	US
Telephone Number	:	281-808-1571
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RICKY MAYES
Credential	:
Telephone Number	:	281-808-1571

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	01/24/2018

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