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General NPI Number Information
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NPI Number | 1255043840
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Entity Type | Organization
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Legal Business Name | AGENCY FOR TREATMENT ENRICHMENT & REHABILITATION LLC
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 5850 SAN FELIPE ST STE 500
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City | HOUSTON
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State | TX
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Zip | 77057-8003
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Country | US
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Telephone | 877-763-5473
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 FOUNTAIN VIEW DR # 1133
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City | HOUSTON
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State | TX
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Zip | 77057-3206
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Country | US
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Telephone | 877-763-5473
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TI ONNA WATSON
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Credential |
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Telephone | 704-956-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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