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General NPI Number Information
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NPI Number | 1780868091
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Entity Type | Organization
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Legal Business Name | WIN
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 707 MARANON LANE
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City | HOUSTON
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State | TX
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Zip | 77090-1309
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Country | US
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Telephone | 713-398-9111
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Fax | 281-444-6328
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Provider Business Mailing Address
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Address Line | 707 MARANON LN
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City | HOUSTON
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State | TX
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Zip | 77090-1309
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Country | US
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Telephone | 713-398-9111
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Fax | 281-444-6328
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CHERYL WHITE PHILLIPS
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Credential |
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Telephone | 713-398-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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