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General NPI Number Information
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NPI Number | 1831405364
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Entity Type | Organization
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Legal Business Name | THE HOUSE OF DAVID GROUP HOME
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Dates
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Enumeration Date | 08/21/2010
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Last Update Date | 08/21/2010
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Provider Practice Location Address
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Address Line | 6422 HILLMAN GLEN CIR
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City | HOUSTON
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State | TX
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Zip | 77086-2834
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Country | US
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Telephone | 713-256-8637
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Fax | 281-448-3632
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Provider Business Mailing Address
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Address Line | 6422 HILLMAN GLEN CIR
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City | HOUSTON
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State | TX
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Zip | 77086-2834
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Country | US
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Telephone | 713-256-8637
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Fax | 281-448-3632
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Authorized Official
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Title or Position | OWNER
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Name | MS. TANIA KIDADA DAVIS
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Credential |
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Telephone | 713-256-8637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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