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General NPI Number Information
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NPI Number | 1972200251
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Entity Type | Organization
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Legal Business Name | RUSSO CARE
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 17302 HOUSE HAHL RD STE 207
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City | CYPRESS
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State | TX
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Zip | 77433-8213
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Country | US
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Telephone | 281-607-1370
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Fax | 832-582-3647
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Provider Business Mailing Address
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Address Line | PO BOX 1394
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City | CYPRESS
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State | TX
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Zip | 77410-1394
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Country | US
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Telephone | 281-607-1370
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Fax | 832-582-3647
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRITTNEY RUSSO
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Credential |
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Telephone | 281-607-1370
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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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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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