Organization
RODRICK'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHRONIA GAY BOURGEOIS (OWNER)
(713) 820-7097
Entity
Organization
Contact information
Practice address
7731 GLENLEA ST, HOUSTON, TX 77061-2111
(713) 820-7097
Mailing address
5900 BALCONES DR # 15814, AUSTIN, TX 78731-4257
(713) 820-7097
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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