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General NPI Number Information
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NPI Number | 1578961603
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Entity Type | Organization
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Legal Business Name | TOWN & COUNTRY TRANSITIONAL LLC
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 900 TOWN AND COUNTRY LN SUITE 225
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City | HOUSTON
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State | TX
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Zip | 77024-2226
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Country | US
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Telephone | 713-927-2864
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Fax |
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Provider Business Mailing Address
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Address Line | 900 TOWN AND COUNTRY LN SUITE 225
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City | HOUSTON
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State | TX
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Zip | 77024-2226
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Country | US
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Telephone | 713-927-2864
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Fax |
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Authorized Official
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Title or Position | OWNER, PSYCHOTHERAPIST
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Name | MS. TRACEY K SMITH
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Credential | MA, NCC, LPC
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Telephone | 713-927-2864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 3699
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License Number State | TX
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