Provider Demographics
NPI:1639341373
Name:HOUSTON COUNTY AWARENESS ASSOCIATION
Entity Type:Organization
Organization Name:HOUSTON COUNTY AWARENESS ASSOCIATION
Other - Org Name:CROCKETT RESOURCE CENTER FOR INDEPENDENT LIVING, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-544-2811
Mailing Address - Street 1:1020 E LOOP 304
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835-1806
Mailing Address - Country:US
Mailing Address - Phone:936-544-2811
Mailing Address - Fax:936-544-7315
Practice Address - Street 1:1020 E LOOP 304
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-1806
Practice Address - Country:US
Practice Address - Phone:936-544-2811
Practice Address - Fax:936-544-7315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management