| Kolaiah's House | |
|
10303 Northwest Fwy Ste 350 Houston TX 77092-8222 | |
| (832) 335-0633 | |
| Not Available |
| Full Name | Kolaiah's House |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 10303 Northwest Fwy Ste 350, Houston, Texas |
| Authorized Official Name and Position | Fredrick W Shaw (OWNER) |
| Authorized Official Contact | 8323350633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kolaiah's House 401 Oriole St Houston TX 77018-6626 Ph: (832) 335-0633 | Kolaiah's House 10303 Northwest Fwy Ste 350 Houston TX 77092-8222 Ph: (832) 335-0633 |
| NPI Number | 1366014755 |
|---|---|
| Provider Enumeration Date | 07/14/2021 |
| Last Update Date | 07/14/2021 |
| Certification Date | 07/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366014755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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