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General NPI Number Information
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NPI Number | 1487913943
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Entity Type | Organization
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Legal Business Name | LIFELINE CHILDREN AND FAMILY SERVICES INC
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 2500 EAST TC JESTER BOULEVARD SUITE # 200
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City | HOUSTON
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State | TX
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Zip | 77008
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Country | US
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Telephone | 866-885-1440
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Fax | 281-715-5569
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Provider Business Mailing Address
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Address Line | 2500 EAST TC JESTER BOULEVARD SUITE # 200
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City | HOUSTON
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State | TX
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Zip | 77008
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Country | US
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Telephone | 866-885-1440
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Fax | 281-715-5569
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RICKY WALTER
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Credential | MA,MS,LCPAA
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Telephone | 866-885-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | TX
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