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NPI 1760427512

NPI 1760427512 : MENELIK GROUP, LLC : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1760427512
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    Entity Type          |    Organization 
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    Legal Business Name  |    MENELIK GROUP, LLC 
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Dates
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    Enumeration Date     |    06/17/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    1310 FRAWLEY ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77009-3428
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    Country              |    US
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    Telephone            |    713-695-3742
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    Fax                  |    713-695-3742
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Provider Business Mailing Address
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    Address Line         |    PO BOX 8747 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77249-8747
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    Country              |    US
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    Telephone            |    713-695-3742
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    Fax                  |    713-695-3742
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Authorized Official
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    Title or Position    |    EHAVIOR &SOCIAL SERVICES DIRECTOR
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    Name                 |    MR. MARTIN TIMOTHY WOODARD 
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    Credential           |    LCSW
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    Telephone            |    713-695-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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