Healthcare Provider Details

I. General information

NPI: 1639371206
Provider Name (Legal Business Name): LAUREN MCKENNA, HCS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17410 E STRACK DR
SPRING TX
77379-8141
US

IV. Provider business mailing address

17410 E STRACK DR
SPRING TX
77379-8141
US

V. Phone/Fax

Practice location:
  • Phone: 713-703-3159
  • Fax:
Mailing address:
  • Phone: 713-703-3159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LAUREN MCKENNA
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 713-703-3159