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General NPI Number Information
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NPI Number | 1376842021
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Entity Type | Organization
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Legal Business Name | RUSSO AND ASSOCIATES
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 5007 FM 1960 RD W #433
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City | HOUSTON
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State | TX
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Zip | 77069-4528
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Country | US
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Telephone | 832-286-7867
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55242
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City | HOUSTON
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State | TX
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Zip | 77255-5242
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Country | US
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Telephone | 832-286-7867
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Fax |
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Authorized Official
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Title or Position | OWNER/PROGRAM MANAGER
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Name | MRS. BRITTNEY RUSSO
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Credential |
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Telephone | 832-286-7867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | TX
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