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Organization

LIFESTREAM BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROSALYN A RUFFIN MA.LMFT.LSOT (CEO)
(713) 480-3534
Entity
Organization

Contact information

Practice address
1270 COUNTY ROAD 2293, CLEVELAND, TX 77327-0299
(713) 480-3534
Mailing address
515A S FRY RD # 306, KATY, TX 77450-2214
(713) 480-3534

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
323P00000X
Psychiatric Residential Treatment Facility
TX
324500000X
Substance Abuse Rehabilitation Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028325101
TX
Enumeration date
04/13/2009
Last updated
03/18/2010
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