Organization
ST. NICHOLAS OPERATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BENJAMIN PEAKES (MANAGER)
(713) 271-7777
Entity
Organization
Contact information
Practice address
4612 HEATHERBROOK DR, DALLAS, TX 75244-7634
(713) 271-7777
(713) 271-8585
Mailing address
11727 S SAM HOUSTON PKWY W, SUITE D, HOUSTON, TX 77031-2342
(713) 271-7777
(713) 271-8585
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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