Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA DELORES MOORE-DAVIS (C.E.O.)
(832) 890-0988
Entity
Organization
Contact information
Practice address
5002 RICKY ST, 5002 RICKY, HOUSTON, TX 77033-4317
(832) 890-0988
(713) 264-0616
Mailing address
5002 RICKY ST, 5002 RICKY, HOUSTON, TX 77033-4317
(832) 567-2659
(713) 264-0616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3445-3446
TX
251S00000X
Community/Behavioral Health Agency
3445-3446
TX
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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