Organization
BACKTOLIFE360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY KIMBROUGH-EDWARDS ED.D (OWNER)
(713) 478-1133
Entity
Organization
Contact information
Practice address
7007 FALL CREEK LN, MISSOURI CITY, TX 77459-3578
(713) 478-1133
Mailing address
7007 FALL CREEK LN, MISSOURI CITY, TX 77459-3578
(713) 478-1133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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