Provider Demographics
NPI:1235387572
Name:GARDEN YOUTH & YOUNG ADULTS CENTER
Entity Type:Organization
Organization Name:GARDEN YOUTH & YOUNG ADULTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-668-8969
Mailing Address - Street 1:PO BOX 53841
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77052-3841
Mailing Address - Country:US
Mailing Address - Phone:713-668-8969
Mailing Address - Fax:
Practice Address - Street 1:10811 RICHMOND AVE
Practice Address - Street 2:134
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-6708
Practice Address - Country:US
Practice Address - Phone:713-668-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency