Healthcare Provider Details

I. General information

NPI: 1508167495
Provider Name (Legal Business Name): UJIMA FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 SOUTHWEST FWY SUITE 561
HOUSTON TX
77074-1615
US

IV. Provider business mailing address

8323 SOUTHWEST FWY SUITE 561
HOUSTON TX
77074-1615
US

V. Phone/Fax

Practice location:
  • Phone: 713-574-9035
  • Fax: 281-888-3675
Mailing address:
  • Phone: 713-574-9035
  • Fax: 281-888-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES HARRIS SR.
Title or Position: ADMINISTRATOR
Credential: LCSW
Phone: 713-574-9035