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General NPI Number Information
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NPI Number | 1336409150
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Entity Type | Organization
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Legal Business Name | MEMORIAL COUNTRY PLACE INC.
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Dates
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Enumeration Date | 05/26/2012
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Last Update Date | 05/26/2012
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Provider Practice Location Address
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Address Line | 783 COUNTRY PLACE DR
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City | HOUSTON
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State | TX
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Zip | 77079-5533
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Country | US
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Telephone | 832-382-6473
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Fax |
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Provider Business Mailing Address
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Address Line | 214 LAUREL GATE TER
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City | HOUSTON
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State | TX
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Zip | 77094-1266
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Country | US
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Telephone | 832-382-6473
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MS. CHAI LIM
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Credential |
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Telephone | 832-382-6473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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