Organization
MDR COMMUNITY LIVING
Active
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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