Provider Demographics
NPI:1275829590
Name:RONNIE ALICE HEALTH SERVICES
Entity Type:Organization
Organization Name:RONNIE ALICE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALERO
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:HANS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:832-245-6481
Mailing Address - Street 1:19403 TASMANIA PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7305
Mailing Address - Country:US
Mailing Address - Phone:832-864-7212
Mailing Address - Fax:
Practice Address - Street 1:19403 TASMANIA PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7305
Practice Address - Country:US
Practice Address - Phone:832-864-7212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities