Organization
VINTAGE BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE IZEKOR (DIRECTOR)
(832) 788-6464
Entity
Organization
Contact information
Practice address
6220 WESTPARK DR STE 149-B225, HOUSTON, TX 77057-7371
(832) 788-6464
Mailing address
6220 WESTPARK DR STE 149-B225, HOUSTON, TX 77057-7371
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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