Provider Demographics
NPI:1417006628
Name:LDS FAMILY SERVICES
Entity Type:Organization
Organization Name:LDS FAMILY SERVICES
Other - Org Name:LDS FAMILY SERVICESTX HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:THEVENIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:281-537-0211
Mailing Address - Street 1:16333 HAFER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-4412
Mailing Address - Country:US
Mailing Address - Phone:281-537-0211
Mailing Address - Fax:281-537-0320
Practice Address - Street 1:16333 HAFER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4412
Practice Address - Country:US
Practice Address - Phone:281-537-0211
Practice Address - Fax:281-537-0320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LDS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX847444 2809251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable