Healthcare Provider Details
I. General information
NPI: 1871795930
Provider Name (Legal Business Name): A.S.U.I HEALTHCARE AND DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2007
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1140 WESTMONT DR STE 415
HOUSTON TX
77015-4368
US
IV. Provider business mailing address
1140 WESTMONT DR STE 415
HOUSTON TX
77015-4368
US
V. Phone/Fax
- Phone: 713-330-0296
- Fax: 713-330-4114
- Phone: 713-330-0296
- Fax: 713-330-4114
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name:
DIANN
SIMIEN
Title or Position: PROGRAM MANAGER
Credential: BACHELOR'S DEGREE
Phone: 713-330-0296