Healthcare Provider Details

I. General information

NPI: 1235709775
Provider Name (Legal Business Name): CARE COMPLETE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21922 BELLAIRE BLVD STE 600
RICHMOND TX
77407-3919
US

IV. Provider business mailing address

16520 STEINHAGEN RD
CYPRESS TX
77429-7173
US

V. Phone/Fax

Practice location:
  • Phone: 832-831-3651
  • Fax: 832-831-3652
Mailing address:
  • Phone: 832-831-3651
  • Fax: 832-831-3652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NECOLE JOHNSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 855-664-0772