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General NPI Number Information
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NPI Number | 1679730485
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Entity Type | Organization
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Legal Business Name | JAYCEE'S CHILDREN CENTER, INC.
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 2902 MILROY LN
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City | HOUSTON
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State | TX
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Zip | 77066-4610
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Country | US
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Telephone | 281-440-5077
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Fax | 281-440-5099
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Provider Business Mailing Address
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Address Line | 2902 MILROY LN
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City | HOUSTON
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State | TX
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Zip | 77066-4610
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Country | US
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Telephone | 281-440-5077
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Fax | 281-440-5099
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. EURADELL MUCKELROY
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Credential | LCCA
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Telephone | 281-440-5077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 537260
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License Number State | TX
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