Provider Demographics
NPI:1467772640
Name:ROSENBERG CMHC INC
Entity Type:Organization
Organization Name:ROSENBERG CMHC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-539-6153
Mailing Address - Street 1:2200 FM 1092 RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1807
Mailing Address - Country:US
Mailing Address - Phone:832-539-6153
Mailing Address - Fax:832-377-3734
Practice Address - Street 1:2200 FM 1092 RD
Practice Address - Street 2:SUITE A
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1807
Practice Address - Country:US
Practice Address - Phone:832-539-6153
Practice Address - Fax:832-377-3734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSENBERG CMHC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-10
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X
TX261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health