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General NPI Number Information
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NPI Number | 1497400287
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Entity Type | Organization
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Legal Business Name | ROGER WILLIAMS ACADEMY
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Dates
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Enumeration Date | 02/20/2022
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 7447 CAMBRIDGE ST APT 47
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City | HOUSTON
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State | TX
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Zip | 77054-2027
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Country | US
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Telephone | 225-394-5997
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Fax |
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Provider Business Mailing Address
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Address Line | 7447 CAMBRIDGE ST APT 47
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City | HOUSTON
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State | TX
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Zip | 77054-2027
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Country | US
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Telephone | 225-394-5997
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Fax |
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Authorized Official
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Title or Position | CEO/CHIEF CLINICAL OFFICER
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Name | MR. GLENN HARRELL
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Credential | BCBA, LBA
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Telephone | 713-859-6709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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