Provider First Line Business Practice Location Address:
12301 MAIN ST
Provider Second Line Business Practice Location Address:
PROFESSIONALS IN CRISIS PROGRAM
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-275-5223
Provider Business Practice Location Address Fax Number:
713-275-5017
Provider Enumeration Date:
05/03/2007