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Organization
ST. MARY'S PLACE, LLC
Active
Organization
ST. MARY'S PLACE, LLC
Active
Other names
The Psych Pro, VOCATIONAL LIVING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CELESTE BASS MA, LPC, LCDC, LSOTP (CEO)
(832) 894-9359
Entity
Organization
Contact information
Practice address
3707 CYPRESS CREEK PKWY, HOUSTON, TX 77068-3526
(832) 894-9359
Mailing address
PO BOX 1838, ALIEF, TX 77411-1838
(832) 894-9359
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4173981-01
—
TX
05
—
4173981-02
—
TX
Enumeration date
11/09/2023
Last updated
11/09/2023
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