Provider Demographics
NPI:1508277716
Name:THE HARRIS CENTER FOR MENTAL HEALTH AND IDD
Entity Type:Organization
Organization Name:THE HARRIS CENTER FOR MENTAL HEALTH AND IDD
Other - Org Name:NORTHEAST CLINIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-970-3385
Mailing Address - Street 1:7200 NORTH LOOP E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-5951
Mailing Address - Country:US
Mailing Address - Phone:713-970-8715
Mailing Address - Fax:713-970-8770
Practice Address - Street 1:7200 NORTH LOOP E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-5951
Practice Address - Country:US
Practice Address - Phone:713-970-8715
Practice Address - Fax:713-970-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292353336C0002X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145615OtherPK