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General NPI Number Information
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NPI Number | 1760836084
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Entity Type | Organization
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Legal Business Name | EXPANDING BEAUTIFUL MINDS LLC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 9723 HOMESTEAD RD
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City | HOUSTON
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State | TX
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Zip | 77016-4403
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Country | US
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Telephone | 832-506-8121
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Fax | 180-091-8697
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Provider Business Mailing Address
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Address Line | 9723 HOMESTEAD RD
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City | HOUSTON
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State | TX
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Zip | 77016-4403
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Country | US
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Telephone | 832-506-8121
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Fax | 180-091-8697
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Authorized Official
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Title or Position | CEO
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Name | D0RA E VILLEGAS
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Credential |
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Telephone | 832-506-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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