1386835270 NPI number — VILLAGE LEARNING CENTER, INC

Table of content: (NPI 1386835270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386835270 NPI number — VILLAGE LEARNING CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILLAGE LEARNING CENTER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VILLAGE HOME & COMMUNITY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386835270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3819 PLUM VALLEY DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-358-6172
Provider Business Mailing Address Fax Number:
281-754-4525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3819 PLUM VALLEY DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-358-6172
Provider Business Practice Location Address Fax Number:
281-754-4525
Provider Enumeration Date:
08/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CONRAD
Authorized Official First Name:
KRISTY
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
281-358-6172

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001007917 . This is a "DADS HCS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001007918 . This is a "HCS DADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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