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General NPI Number Information
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NPI Number | 1902534274
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Entity Type | Organization
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Legal Business Name | COMPASSION-FIRST GROUP HOME LLC
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 8014 CHANTILLY MNR
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City | FULSHEAR
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State | TX
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Zip | 77441-2362
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Country | US
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Telephone | 310-721-0438
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Fax |
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Provider Business Mailing Address
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Address Line | 8014 CHANTILLY MNR
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City | FULSHEAR
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State | TX
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Zip | 77441-2362
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Country | US
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Telephone | 310-721-0438
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | FATIMA S DAVIES
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Credential |
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Telephone | 310-721-0438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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