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General NPI Number Information
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NPI Number | 1033345319
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Entity Type | Organization
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Legal Business Name | MONTGOMERY EMPOWERMENT CORPORATION
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 10630 HOMESTEAD RD
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City | HOUSTON
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State | TX
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Zip | 77016-2704
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Country | US
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Telephone | 713-454-4929
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Fax |
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Provider Business Mailing Address
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Address Line | 10630 HOMESTEAD RD
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City | HOUSTON
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State | TX
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Zip | 77016-2704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DAVID MONTGOMER
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Credential |
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Telephone | 713-454-4929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 25K100000X
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 251S00000X
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 320800000X
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 251B00000X
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License Number State | TX
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