Provider Demographics
NPI:1639373855
Name:NIKKI CHILDREN'S HOME
Entity Type:Organization
Organization Name:NIKKI CHILDREN'S HOME
Other - Org Name:NCH OUTREACH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-838-7362
Mailing Address - Street 1:9402 BEVLYN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4306
Mailing Address - Country:US
Mailing Address - Phone:713-838-7362
Mailing Address - Fax:713-667-1136
Practice Address - Street 1:9402 BEVLYN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-4306
Practice Address - Country:US
Practice Address - Phone:713-838-7362
Practice Address - Fax:713-667-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX839449322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children