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General NPI Number Information
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NPI Number | 1861940934
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Entity Type | Organization
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Legal Business Name | PEACE & SOBRIETY TREATMENT CENTER
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 8507 MORNING OAK LN
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City | CYPRESS
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State | TX
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Zip | 77433-1504
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Country | US
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Telephone | 832-530-6513
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Fax |
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Provider Business Mailing Address
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Address Line | 8507 MORNING OAK LN
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City | CYPRESS
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State | TX
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Zip | 77433-1504
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Country | US
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Telephone | 832-530-6513
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Fax |
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MRS. NICOLETTE HINES
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Credential | LCDC
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Telephone | 832-530-6513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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