Healthcare Provider Details

I. General information

NPI: 1184850976
Provider Name (Legal Business Name): FAMILY RESOURCE OF GREATER HOUSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2009
Last Update Date: 06/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 HARWIN DR SUITE #218
HOUSTON TX
77036-2129
US

IV. Provider business mailing address

7111 HARWIN DR SUITE #218
HOUSTON TX
77036-2129
US

V. Phone/Fax

Practice location:
  • Phone: 504-258-9174
  • Fax:
Mailing address:
  • Phone: 504-258-9174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 504-258-9174