=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700048774
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOUSTON ACHIEVEMENT PLACE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2008
-----------------------------------------------------
Last Update Date | 06/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 245 W 17TH ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-4001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-868-1943
-----------------------------------------------------
Fax | 713-868-4823
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 245 W 17TH ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-4001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-868-1943
-----------------------------------------------------
Fax | 713-868-4823
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. PAUL GILFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-868-1943
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------