Provider Demographics
NPI:1588658454
Name:RUSSIAN COMMUNITY SERVICES,INC
Entity Type:Organization
Organization Name:RUSSIAN COMMUNITY SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KISLYUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-778-0520
Mailing Address - Street 1:PO BOX 606
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0606
Mailing Address - Country:US
Mailing Address - Phone:713-778-0520
Mailing Address - Fax:713-772-1810
Practice Address - Street 1:6410 INDIGO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-7203
Practice Address - Country:US
Practice Address - Phone:713-778-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113568261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care