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NPI 1578841805

NPI 1578841805 : KDOVE FOUNDATION : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1578841805
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    Entity Type          |    Organization 
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    Legal Business Name  |    KDOVE FOUNDATION 
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Dates
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    Enumeration Date     |    08/04/2011
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    Last Update Date     |    08/04/2011
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Provider Practice Location Address
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    Address Line         |    13414 ENSLEY WOOD DR 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77082-5020
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    Country              |    US
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    Telephone            |    832-217-6815
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    Fax                  |    832-204-4514
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Provider Business Mailing Address
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    Address Line         |    13414 ENSLEY WOOD DR 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77082-5020
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    Country              |    US
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    Telephone            |    832-217-6815
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    Fax                  |    832-204-4514
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SHEILA  MOODY 
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    Credential           |    
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    Telephone            |    832-217-6815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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