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General NPI Number Information
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NPI Number | 1841064136
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Entity Type | Organization
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Legal Business Name | ANCHORAGE HOUSE LLC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 2511 BAMMEL TIMBERS LN
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City | HOUSTON
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State | TX
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Zip | 77068-3303
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Country | US
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Telephone | 832-728-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 BAMMEL TIMBERS LN
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City | HOUSTON
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State | TX
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Zip | 77068-3303
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Country | US
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Telephone | 832-728-6220
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Fax |
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Authorized Official
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Title or Position | LICENSED CHILD CARE ADMINISTRATOR
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Name | CONSTANCE PHILLIPS
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Credential | MSCJ, LCDC, CDVC
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Telephone | 832-706-7364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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