MEDICARE: HOLDEN VOCATIONAL SERVICES

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1366803132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLDEN VOCATIONAL SERVICES

Provider Business Mailing Address
First Line	:	3724 FM 1960 RD W
Second Line	:	SUITE 300M
City	:	HOUSTON
State	:	TX
Zip	:	77068-3528
Country	:	US
Telephone Number	:	281-883-2265
Fax Number	:	832-458-2730

Provider Business Practice Location Address
First Line	:	3724 FM 1960 WEST
Second Line	:	SUITE 300 M
City	:	HOUSTON
State	:	TX
Zip	:	77068
Country	:	US
Telephone Number	:	281-883-2265
Fax Number	:	832-458-2730

Authorized Official
Title or Position	:	CRP DIRECTOR
Name	:	MRS. LENA MARIE HOLDEN
Credential	:	MED
Telephone Number	:	281-883-2265

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	03/08/2016

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