Organization
INSTITUTE OF DYNAMIC BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE NGOZI WILLIAMS (ADMINISTRATOR)
(832) 239-2152
Entity
Organization
Contact information
Practice address
3119 MULBERRY RANCH DRIVE, KATY, TX 77494-3620
(832) 239-2152
(281) 574-9026
Mailing address
3119 MULBERRY RANCH DR, KATY, TX 77494-3026
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004516
—
TX
Enumeration date
04/16/2012
Last updated
04/16/2012
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