Provider Demographics
NPI:1275314676
Name:BRAZOS BEND GUARDIANSHIP SERVICES
Entity Type:Organization
Organization Name:BRAZOS BEND GUARDIANSHIP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:KIRK
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:281-232-7701
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-0072
Mailing Address - Country:US
Mailing Address - Phone:281-232-7701
Mailing Address - Fax:281-310-8700
Practice Address - Street 1:830 3RD ST STE 209
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2508
Practice Address - Country:US
Practice Address - Phone:281-232-7701
Practice Address - Fax:281-310-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty