Provider Demographics
NPI:1073750121
Name:ALL GODS CHILDREN HEALTH AND D-HAB
Entity Type:Organization
Organization Name:ALL GODS CHILDREN HEALTH AND D-HAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-243-1803
Mailing Address - Street 1:233 HOLTMAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-5735
Mailing Address - Country:US
Mailing Address - Phone:832-243-1803
Mailing Address - Fax:
Practice Address - Street 1:233 HOLTMAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-5735
Practice Address - Country:US
Practice Address - Phone:832-243-1803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization