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General NPI Number Information
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NPI Number | 1912553942
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Entity Type | Organization
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Legal Business Name | FOSTERING A BRIGHTER TOMORROW LLC
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 260 N SAM HOUSTON PKWY E STE 350
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City | HOUSTON
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State | TX
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Zip | 77060
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Country | US
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Telephone | 832-293-0647
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 PIONEER AVE STE 403
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City | CHEYENNE
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State | WY
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Zip | 82001-4406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | D B
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Credential |
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Telephone | 832-293-0647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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