Individual
MS. FLORENCE N BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11122 COLEBROOK DR, HOUSTON, TX 77072-1922
(713) 667-8307
(713) 520-7623
Mailing address
PO BOX 300079, HOUSTON, TX 77230-0079
(713) 303-1325
(713) 520-7623
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
311ZA0620X
Adult Care Home Facility
—
TX
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
86H
TX
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
COMPONENT CODE86H
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86H (001007690)
—
TX
05
—
86H (001007692)
—
TX
Enumeration date
11/04/2006
Last updated
05/09/2019
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