Provider Demographics
NPI:1376842021
Name:RUSSO AND ASSOCIATES
Entity Type:Organization
Organization Name:RUSSO AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-286-7867
Mailing Address - Street 1:PO BOX 55242
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77255-5242
Mailing Address - Country:US
Mailing Address - Phone:832-286-7867
Mailing Address - Fax:
Practice Address - Street 1:5007 FM 1960 RD W
Practice Address - Street 2:#433
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4528
Practice Address - Country:US
Practice Address - Phone:832-286-7867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities