Basic Information
| Provider Information | |||||||||
| NPI: | 1265528798 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE HARRIS CENTER FOR MENTAL HEALTH AND IDD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9401 SOUTHWEST FWY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770741407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139707000 | ||||||||
| FaxNumber: | 7139707246 | ||||||||
| Practice Location | |||||||||
| Address1: | 9401 SOUTHWEST FWY | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770741407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139707000 | ||||||||
| FaxNumber: | 7139707246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 01/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | SCHNEE | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7139707000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 315P00000X | N | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mentally Retarded | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 320900000X | Y | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
ID Information
| ID | Type | State | Issuer | Description | 001007288 | 01 | TX | STATE VENDOR ID# HCS | OTHER | 000781801 | 05 | TX | MEDICAID | 001010312 | 01 | TX | STATE VENDOR ID# TX HML | OTHER | 000780701 | 05 | TX | MEDICAID | 000368801 | 05 | TX | MEDICAID | 000372101 | 05 | TX | MEDICAID | 000391002 | 05 | TX | MEDICAID |