Provider Demographics
NPI:1477177814
Name:DR. PHAETRA K. RANEY FOUNDATION INC.
Entity Type:Organization
Organization Name:DR. PHAETRA K. RANEY FOUNDATION INC.
Other - Org Name:DAMASCUS LANDING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHAETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCSW
Authorized Official - Phone:832-363-7877
Mailing Address - Street 1:19901 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6538
Mailing Address - Country:US
Mailing Address - Phone:832-363-7877
Mailing Address - Fax:
Practice Address - Street 1:19901 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6538
Practice Address - Country:US
Practice Address - Phone:281-665-7346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health