Provider Demographics
NPI:1336328095
Name:ATCG LLC
Entity Type:Organization
Organization Name:ATCG LLC
Other - Org Name:AMERICAN THERAPY CONSULTING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REX
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-260-0821
Mailing Address - Street 1:PO BOX 14673
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-4673
Mailing Address - Country:US
Mailing Address - Phone:281-260-0821
Mailing Address - Fax:281-260-0352
Practice Address - Street 1:530 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4026
Practice Address - Country:US
Practice Address - Phone:280-260-0821
Practice Address - Fax:281-260-0352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156168003Medicaid
TX00572VMedicare PIN