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General NPI Number Information
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NPI Number | 1669806634
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Entity Type | Organization
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Legal Business Name | SET FREE D.A.T. CENTER, INC.
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 3333 FANNIN ST SUITE NUMBER 111
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City | HOUSTON
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State | TX
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Zip | 77004-2950
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Country | US
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Telephone | 713-520-8042
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Fax | 713-942-7866
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Provider Business Mailing Address
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Address Line | 3333 FANNIN ST SUITE NUMBER 111
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City | HOUSTON
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State | TX
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Zip | 77004-2950
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Country | US
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Telephone | 713-520-8042
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Fax | 713-942-7866
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGY/PROGRAM MANAGER
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Name | MR. MOORE ABBOTT
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Credential | M.A., LCDC
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Telephone | 832-578-2924
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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 | 1778 - 1778 A
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License Number State | TX
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