Provider Demographics
NPI:1659004455
Name:EFFECTIVE RESTORATIVE CENTER
Entity Type:Organization
Organization Name:EFFECTIVE RESTORATIVE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHECHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LCDC
Authorized Official - Phone:346-242-0275
Mailing Address - Street 1:9950 WESTPARK DR STE 434
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5271
Mailing Address - Country:US
Mailing Address - Phone:832-365-6624
Mailing Address - Fax:281-533-8007
Practice Address - Street 1:9950 WESTPARK DR STE 434
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5271
Practice Address - Country:US
Practice Address - Phone:832-365-6624
Practice Address - Fax:281-533-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX37745808OtherTHE TEXAS DEPARTMENT OF PUBLIC SAFETY