Healthcare Provider Details

I. General information

NPI: 1205169554
Provider Name (Legal Business Name): VISIONARY COMMUNITY HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5103 LANGLEY RD
HOUSTON TX
77016-2917
US

IV. Provider business mailing address

5103 LANGLEY RD
HOUSTON TX
77016-2917
US

V. Phone/Fax

Practice location:
  • Phone: 713-633-7444
  • Fax: 713-633-7444
Mailing address:
  • Phone: 713-633-7444
  • Fax: 713-633-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. GWENDOLYN KAY FRANK
Title or Position: OWNER
Credential:
Phone: 832-665-8218