Organization
EDDIE LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERRIE LA'NIECE THOMPSON-JACKSON DIRECTOR OF OPERATIO (EXECUTIVE DIRECTOR)
(281) 541-5318
Entity
Organization
Contact information
Practice address
5509 WIPPRECHT ST, HOUSTON, TX 77026-1741
(713) 633-0042
(281) 749-8228
Mailing address
PO BOX 671646, HOUSTON, TX 77267-1646
(713) 633-0042
(281) 749-8228
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
1238428
TX
320800000X
Mental Illness Community Based Residential Treatment Facility
1238428
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1238428
TX
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
1238428
TX
Other
Enumeration date
08/26/2011
Last updated
02/08/2013
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