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General NPI Number Information
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NPI Number | 1568276749
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Entity Type | Organization
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Legal Business Name | TED CARE VI LLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 2000 CRAWFORD ST STE 1123
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City | HOUSTON
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State | TX
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Zip | 77002-9000
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Country | US
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Telephone | 612-669-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 FANNIN ST STE 262
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City | HOUSTON
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State | TX
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Zip | 77002-6943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIK LAIN
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Credential |
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Telephone | 612-669-6355
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 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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