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General NPI Number Information
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NPI Number | 1801610241
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Entity Type | Organization
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Legal Business Name | ADEWOLE BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 12/25/2024
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Provider Practice Location Address
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Address Line | 13223 ELDRIDGE CHASE
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City | HOUSTON
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State | TX
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Zip | 77041-1757
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Country | US
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Telephone | 346-529-7822
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Fax |
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Provider Business Mailing Address
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Address Line | 13223 ELDRIDGE CHASE
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City | HOUSTON
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State | TX
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Zip | 77041-1757
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Country | US
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Telephone | 346-529-7822
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. JERONE BRACEY
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Credential |
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Telephone | 346-529-7822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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