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General NPI Number Information
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NPI Number | 1124338603
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Entity Type | Organization
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Legal Business Name | GD MILESTONE COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 6903 RED OAK 272
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City | HOUSTON
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State | TX
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Zip | 77090
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Country | US
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Telephone | 281-444-1191
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Fax | 281-444-1194
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Provider Business Mailing Address
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Address Line | PO BOX 941836
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City | HOUSTON
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State | TX
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Zip | 77094
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Country | US
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Telephone | 281-444-1191
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Fax | 281-444-1194
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Authorized Official
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Title or Position | PREIDENT
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Name | MRS. DANAVIAN SIMS
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Credential |
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Telephone | 281-444-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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