Healthcare Provider Details

I. General information

NPI: 1609014992
Provider Name (Legal Business Name): BOYS AND GIRLS COUNTRY OF HOUSTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18806 ROBERTS RD
HOCKLEY TX
77447-9327
US

IV. Provider business mailing address

18806 ROBERTS RD
HOCKLEY TX
77447-9327
US

V. Phone/Fax

Practice location:
  • Phone: 281-351-4976
  • Fax: 281-351-4978
Mailing address:
  • Phone: 281-351-4976
  • Fax: 281-351-4978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY ANN WRIGHT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 281-351-4976