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General NPI Number Information
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NPI Number | 1457796336
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Entity Type | Organization
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Legal Business Name | HOUSTON SUBSTANCE ABUSE CLINIC, INC.
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 7428 PARK PLACE BLVD
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City | HOUSTON
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State | TX
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Zip | 77087-4442
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Country | US
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Telephone | 713-643-5858
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Fax | 713-643-2967
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Provider Business Mailing Address
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Address Line | 7428 PARK PLACE BLVD
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City | HOUSTON
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State | TX
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Zip | 77087-4442
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Country | US
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Telephone | 713-643-5858
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Fax | 713-643-2967
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MS. DARLENE ROBERTSON
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Credential |
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Telephone | 337-351-5341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | TX-10113-M
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License Number State | TX
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