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General NPI Number Information
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NPI Number | 1386882124
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Entity Type | Organization
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Legal Business Name | CHURCH OF CHRIST IN FRIENDSWOOD
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 2051 W PARKWOOD AVE
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-8910
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Country | US
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Telephone | 281-482-3882
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Fax | 281-482-9430
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Provider Business Mailing Address
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Address Line | 2051 W PARKWOOD AVE
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-8910
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Country | US
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Telephone | 281-482-3882
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Fax | 281-482-9430
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Authorized Official
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Title or Position | COUNSELOR
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Name | MICHAEL D. ROSS
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Credential | LCSW
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Telephone | 281-482-3882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 06173
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License Number State | TX
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