Basic Information
| Provider Information | |||||||||
| NPI: | 1003282039 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SUN HOUSTON, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SUN BEHAVIORAL HOUSTON | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 BROAD ST | ||||||||
| Address2: | SUITE 403 | ||||||||
| City: | RED BANK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077011938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327471800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7601 FANNIN ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770541905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137962273 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2015 | ||||||||
| LastUpdateDate: | 11/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | ARNETT | ||||||||
| AuthorizedOfficialFirstName: | CHARLENE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7137962273 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SUN BEHAVIORAL HEALTH, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.