1154817450 NPI number — HOUSTON AREA COMMUNITY SERVICES, INC.

Table of content: (NPI 1154817450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154817450 NPI number — HOUSTON AREA COMMUNITY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSTON AREA COMMUNITY SERVICES, 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:
AVENUE 360 NORTHEAST
Provider Other Organization Name Type Code:
5
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:
1154817450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2150 W. 18TH STREET
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-426-0027
Provider Business Mailing Address Fax Number:
832-209-7186

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18842 S MEMORIAL DR STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMBLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77338-4229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-570-2525
Provider Business Practice Location Address Fax Number:
832-644-9596
Provider Enumeration Date:
07/10/2018

Additional Information

Authorized Official

Authorized Official Last Name:
HENDERSON
Authorized Official First Name:
TEQUILA
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE CYCLE DIRECTOR
Authorized Official Telephone Number:
713-426-0027

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com