Organization
MAINSTREAM LIVING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL H CUNNINGHAM (CEO)
(281) 865-2003
Entity
Organization
Contact information
Practice address
11811 NORTH FWY STE 615, HOUSTON, TX 77060-3239
(281) 999-5112
(281) 999-5113
Mailing address
13940 BAMMEL N. HOUSTON, SUITE 304, HOUSTON, TX 77066
(281) 440-5103
(281) 440-5105
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
001008149
TX
Other
Enumeration date
05/25/2007
Last updated
12/23/2019
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