Provider Demographics
NPI:1083916977
Name:KATHERINE ATWOOD
Entity Type:Organization
Organization Name:KATHERINE ATWOOD
Other - Org Name:PARAKLETOS COMFORT LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:281-217-0735
Mailing Address - Street 1:12801 KYLEWICK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-1705
Mailing Address - Country:US
Mailing Address - Phone:281-217-0735
Mailing Address - Fax:281-431-8402
Practice Address - Street 1:12801 KYLEWICK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-1705
Practice Address - Country:US
Practice Address - Phone:281-217-0735
Practice Address - Fax:281-431-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-26
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTPI205602001Medicaid
TX1174748537OtherNPI