Organization
NOSSTOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL DOTSON (ADMINISTRATOR)
(713) 434-5007
Entity
Organization
Contact information
Practice address
5411 LYNDHURST DR, HOUSTON, TX 77033-2911
(281) 773-1842
Mailing address
3110 EBBTIDE DR, HOUSTON, TX 77045-4508
(713) 434-5007
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/16/2008
Last updated
07/16/2008
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