Organization
MDR COMMUNITY LIVING
Active
Other names
MDR Community Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD LAMONTE LEWIS (PROGRAM ADMINSTRATOR)
(832) 455-6303
Entity
Organization
Contact information
Practice address
6000 HOLLISTER ST APT 2711, HOUSTON, TX 77040-6878
(832) 455-6303
Mailing address
6000 HOLLISTER ST APT 2711, HOUSTON, TX 77040-6878
(832) 455-6303
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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