Provider Demographics
NPI:1225362338
Name:SHAMAR HOPE HAVEN RESIDENTIAL TREATMENT CENTER
Entity Type:Organization
Organization Name:SHAMAR HOPE HAVEN RESIDENTIAL TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LCCA
Authorized Official - Phone:713-942-8822
Mailing Address - Street 1:2719 TRUXILLO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5455
Mailing Address - Country:US
Mailing Address - Phone:713-942-8822
Mailing Address - Fax:
Practice Address - Street 1:2719 TRUXILLO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5455
Practice Address - Country:US
Practice Address - Phone:713-942-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2099A3245S0500X
TX8380673245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children