Organization
NOAH'S GLEN RESIDENTIAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUDLEY T FARENTHOLD LCSW (CEO)
(713) 683-9144
Entity
Organization
Contact information
Practice address
2121 MANSFIELD ST, HOUSTON, TX 77091-4033
(713) 683-9144
(713) 683-9143
Mailing address
2121 MANSFIELD ST, HOUSTON, TX 77091-4033
(713) 683-9144
(713) 683-9143
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
2362A
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2362A
DSHS
TX
Enumeration date
12/27/2006
Last updated
08/22/2020
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