MEDICARE: SOUTH CENTRAL HOUSTON ACTION COUNCIL, INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417036534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH CENTRAL HOUSTON ACTION COUNCIL, INC.

Provider Business Mailing Address
First Line	:	P.O. BOX 300345
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77230-0345
Country	:	US
Telephone Number	:	713-734-4580
Fax Number	:	713-734-1564

Provider Business Practice Location Address
First Line	:	8610 MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-2308
Country	:	US
Telephone Number	:	713-734-0199
Fax Number	:	713-734-1564

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MARCUS A ROLAND
Credential	:
Telephone Number	:	713-734-4580

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/24/2010

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