MEDICARE: G-WILL TALK MINISTRIES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	251E00000X	Home Health Agency
3	261QR0800X	Recovery Care Clinic/Center
4	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1598295073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G-WILL TALK MINISTRIES

Provider Business Mailing Address
First Line	:	3707 WESTCENTER DR STE 188
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-5292
Country	:	US
Telephone Number	:	713-487-6328
Fax Number	:	832-553-1897

Provider Business Practice Location Address
First Line	:	3707 WESTCENTER DR STE 190
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-5239
Country	:	US
Telephone Number	:	713-487-6328
Fax Number	:	713-487-6328

Authorized Official
Title or Position	:	ACCOUNTANT
Name	:	MICHAEL LOCKE
Credential	:
Telephone Number	:	832-630-1702

Provider Enumeration Date	:	06/15/2017
Last Update Date	:	06/15/2017

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Directions to “G-WILL TALK MINISTRIES ” Practice Location

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