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General NPI Number Information
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NPI Number | 1962632687
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Entity Type | Organization
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Legal Business Name | COURAGE TO CHANGE, INC.
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 18065 UPPER BAY RD STE 209
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City | HOUSTON
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State | TX
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Zip | 77058-3549
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Country | US
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Telephone | 713-679-8767
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Fax |
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Provider Business Mailing Address
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Address Line | 18065 UPPER BAY RD STE 209
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City | HOUSTON
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State | TX
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Zip | 77058-3549
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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 | ADMINISTRATOR
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Name | DR. EDWARD ALEXANDER BIRTS
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Credential | PHD
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Telephone | 713-679-8767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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