Organization
VISIBLE IMAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD MCWILLIAMS (EXECUTIVE DIRECTOR)
(713) 373-6775
Entity
Organization
Contact information
Practice address
6201 BONHOMME RD, SUITE 388N, HOUSTON, TX 77036-4365
(713) 785-2233
Mailing address
15350 E HUTCHINSON CIR, HOUSTON, TX 77071-3328
(713) 373-6775
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
253J00000X
Foster Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
TX
302F00000X
Exclusive Provider Organization
—
TX
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
TX
385H00000X
Respite Care
801126049
TX
Other
Enumeration date
05/29/2011
Last updated
05/29/2011
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