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General NPI Number Information
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NPI Number | 1588902035
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Entity Type | Organization
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Legal Business Name | ADDICTS CAN BE DISCIPLES TOO
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 3711 SOUTHMORE BLVD APT 1115 1415CUSHING ST
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City | HOUSTON
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State | TX
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Zip | 77004-7948
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Country | US
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Telephone | 713-659-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 3711 SOUTHMORE BLVD APT 1115 1415CUSHING ST
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City | HOUSTON
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State | TX
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Zip | 77004-7948
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Country | US
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Telephone | 713-659-7700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SHIRLEY R PALMER
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Credential | CERTIFIED FAITH-BASE
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Telephone | 713-529-2840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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