MEDICARE: CENTER FOR BEHAVIORAL HEALTH PLLC

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
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	S02069	TX

General Provider Information

NPI Number	:	1912082371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	176 UVALDE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-1506
Country	:	US
Telephone Number	:	713-455-7008
Fax Number	:	713-455-4870

Provider Business Practice Location Address
First Line	:	176 UVALDE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-1506
Country	:	US
Telephone Number	:	713-455-7008
Fax Number	:	713-455-4870

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. AMOS E OZUMBA
Credential	:	ED.D,LMSW-AP,LCDC
Telephone Number	:	713-455-7008

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	09/21/2007

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