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General NPI Number Information
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NPI Number | 1467743583
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR PEACE
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Dates
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Enumeration Date | 04/23/2011
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Last Update Date | 04/23/2011
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Provider Practice Location Address
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Address Line | 16318 ANGEL ISLAND LN
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City | HOUSTON
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State | TX
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Zip | 77053-4334
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Country | US
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Telephone | 281-827-0655
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Fax |
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Provider Business Mailing Address
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Address Line | 3139 W HOLCOMBE BLVD 272
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City | HOUSTON
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State | TX
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Zip | 77025-1505
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Country | US
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Telephone | 281-827-0655
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JANA GASTON-COACHMAN
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Credential | LPC
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Telephone | 281-827-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 67395
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License Number State | TX
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