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General NPI Number Information
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NPI Number | 1689962508
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Entity Type | Organization
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Legal Business Name | CITY CROWN PHP INC
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 2626 RAVEN FALLS LN
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-6072
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Country | US
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Telephone | 832-326-9028
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Fax | 281-992-2187
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Provider Business Mailing Address
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Address Line | 2626 RAVEN FALLS LN
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-6072
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Country | US
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Telephone | 832-326-9028
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Fax | 281-992-2187
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Authorized Official
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Title or Position | CEO
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Name | MS. VERONICA UZOAMAKA OKAFOR
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Credential |
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Telephone | 832-326-9028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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