Provider Demographics
NPI:1194455139
Name:SANINA HUDSON CORPORATION
Entity Type:Organization
Organization Name:SANINA HUDSON CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-615-9342
Mailing Address - Street 1:5600 S WILLOW DR STE 206
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4700
Mailing Address - Country:US
Mailing Address - Phone:773-615-9342
Mailing Address - Fax:
Practice Address - Street 1:5600 S WILLOW DR STE 206
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4700
Practice Address - Country:US
Practice Address - Phone:773-615-9342
Practice Address - Fax:713-584-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities