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General NPI Number Information
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NPI Number | 1528680253
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Entity Type | Organization
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Legal Business Name | MINOR TO MAJOR LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 11811 NORTH FWY STE 500
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City | HOUSTON
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State | TX
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Zip | 77060-3287
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Country | US
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Telephone | 210-612-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 11811 NORTH FWY STE 500
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City | HOUSTON
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State | TX
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Zip | 77060-3287
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Country | US
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Telephone | 210-612-0272
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | JEREMY JERMEL RANKINS
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Credential | LPC
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Telephone | 210-612-0272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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