Basic Information
| Provider Information | |||||||||
| NPI: | 1346293156 | ||||||||
| EntityType: | 2 | ||||||||
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| 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: | 77074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139707000 | ||||||||
| FaxNumber: | 7139707246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 04/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | HONEYCUTT | ||||||||
| AuthorizedOfficialFirstName: | EVA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, REVENUE MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 7139707359 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD1600X | N | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 029158501 | 05 | TX | MEDICAID | 091743701 | 05 | TX | MEDICAID | 113180703 | 05 | TX | MEDICAID | 113180702 | 05 | TX | MEDICAID | 113180705 | 05 | TX | MEDICAID |