MEDICARE: SANTUS HEALING HANDS ADOLESCENT TREATMENT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3245S0500X	Children's Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1184892861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTUS HEALING HANDS ADOLESCENT TREATMENT CENTER

Provider Business Mailing Address
First Line	:	9894 BISSONNET ST
Second Line	:	SUITE 790
City	:	HOUSTON
State	:	TX
Zip	:	77036-8239
Country	:	US
Telephone Number	:	713-981-5777
Fax Number	:	713-981-8501

Provider Business Practice Location Address
First Line	:	14402 MINETTA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-6522
Country	:	US
Telephone Number	:	713-981-5777
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. UCHE MCHENRY
Credential	:
Telephone Number	:	713-981-5777

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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