Healthcare Provider Details

I. General information

NPI: 1972384469
Provider Name (Legal Business Name): 106BH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8717 HUMBLE WESTFIELD RD BLDG A
HUMBLE TX
77338-4436
US

IV. Provider business mailing address

8717 HUMBLE WESTFIELD RD BLDG A
HUMBLE TX
77338-4436
US

V. Phone/Fax

Practice location:
  • Phone: 346-842-0424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JON NATHAN FORD
Title or Position: MANAGER
Credential:
Phone: 346-842-0424