Healthcare Provider Details

I. General information

NPI: 1962564492
Provider Name (Legal Business Name): WESTWOOD BAPTIST CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11714 SUMMER BROOK CT
PEARLAND TX
77584-7205
US

IV. Provider business mailing address

11714 SUMMER BROOK CT
PEARLAND TX
77584-7205
US

V. Phone/Fax

Practice location:
  • Phone: 713-436-5623
  • Fax: 713-436-5623
Mailing address:
  • Phone: 713-436-5623
  • Fax: 713-436-5623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ALBERT A. KEMP
Title or Position: CO-OWNER
Credential:
Phone: 713-436-5623