Basic Information
| Provider Information | |||||||||
| NPI: | 1821428657 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOLUTIONS FOR BETTER LIVING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4500 MONTROSE BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770065800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812363989 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4500 MONTROSE BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770065800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812363989 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2013 | ||||||||
| LastUpdateDate: | 09/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | JACKSON | ||||||||
| AuthorizedOfficialFirstName: | VALERIE | ||||||||
| AuthorizedOfficialMiddleName: | DARICE | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2812363989 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | 36927 | TX | Y | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 329866301 | 05 | TX | MEDICAID |