Basic Information
| Provider Information | |||||||||
| NPI: | 1639752124 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOUSTON AREA COMMUNITY SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 W 18TH ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770081289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134260027 | ||||||||
| FaxNumber: | 8322097186 | ||||||||
| Practice Location | |||||||||
| Address1: | 2920 FANNIN ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133413790 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2021 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | PEER | ||||||||
| AuthorizedOfficialFirstName: | APRIL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 7134260027 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HOUSTON AREA COMMUNITY SERVICES, INC. | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.