Healthcare Provider Details

I. General information

NPI: 1417779075
Provider Name (Legal Business Name): GCOS A HELPING HAND FOUNDATION TX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 KINSDALE AVE
DICKINSON TX
77539-6152
US

IV. Provider business mailing address

2435 KINSDALE AVE
DICKINSON TX
77539-6152
US

V. Phone/Fax

Practice location:
  • Phone: 405-326-8700
  • Fax:
Mailing address:
  • Phone: 405-326-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: EDNA JAMES
Title or Position: DIRECTOR
Credential:
Phone: 405-326-8700