Individual
ALICE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6855 S MASON RD APT 1108, KATY, TX 77450-1233
(313) 717-1774
Mailing address
6855 S MASON RD APT 1108, KATY, TX 77450-1233
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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