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General NPI Number Information
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NPI Number | 1659982437
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Entity Type | Organization
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Legal Business Name | OLIVER-WEST HEALTH AND WELLNESS CENTER
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 9009 BOONE RD STE A
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City | HOUSTON
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State | TX
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Zip | 77099-2033
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Country | US
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Telephone | 281-935-4251
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Fax |
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Provider Business Mailing Address
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Address Line | 9009 BOONE RD STE A
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City | HOUSTON
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State | TX
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Zip | 77099-2033
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Country | US
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Telephone | 281-935-4251
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Fax |
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Authorized Official
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Title or Position | DRECTOR
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Name | ANTHONY WEST
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Credential |
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Telephone | 291-935-4251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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