Organization
MASTERS ANVIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD JESSIE RUSSELL (SUPERIENTENDENT)
(281) 881-6707
Entity
Organization
Contact information
Practice address
1554 GEARS RD, HOUSTON, TX 77067-4104
(281) 881-6707
Mailing address
1554 GEARS RD, HOUSTON, TX 77067-4104
(281) 881-6707
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/21/2008
Last updated
12/21/2008
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