Provider Demographics
NPI:1295010130
Name:COALESCE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:COALESCE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-534-1371
Mailing Address - Street 1:8411 W BELLFORT ST
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2205
Mailing Address - Country:US
Mailing Address - Phone:713-534-1371
Mailing Address - Fax:832-767-3762
Practice Address - Street 1:8411 W BELLFORT ST
Practice Address - Street 2:SUITE 110B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2205
Practice Address - Country:US
Practice Address - Phone:713-534-1371
Practice Address - Fax:832-767-3762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)