1851548580 NPI number — SHIFA CMHC OF TEXAS LLC

Table of content: (NPI 1851548580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851548580 NPI number — SHIFA CMHC OF TEXAS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHIFA CMHC OF TEXAS LLC
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:
Provider Other Organization Name Type Code:
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:
1851548580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7916 WRENWOOD BLVD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70809-1782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-927-7878
Provider Business Mailing Address Fax Number:
225-927-7787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8500 HILLCROFT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77096-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-771-1222
Provider Business Practice Location Address Fax Number:
713-771-1716
Provider Enumeration Date:
08/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORELLA
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CFO/MEMBER
Authorized Official Telephone Number:
225-927-7878

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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