Provider Demographics
NPI:1629332267
Name:L. I. P. LIVING IN PURPOSE HEALTH CARE INC.
Entity Type:Organization
Organization Name:L. I. P. LIVING IN PURPOSE HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-250-6682
Mailing Address - Street 1:P. O. BOX 11303
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77293
Mailing Address - Country:US
Mailing Address - Phone:832-250-6682
Mailing Address - Fax:281-812-3352
Practice Address - Street 1:2900 LUELL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-7634
Practice Address - Country:US
Practice Address - Phone:832-250-6682
Practice Address - Fax:281-812-3352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L. I. P. LIVING IN PURPOSE HEALTH CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-28
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization