Provider Demographics
NPI:1699032003
Name:FAITH NETWORK LLC
Entity Type:Organization
Organization Name:FAITH NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-988-3900
Mailing Address - Street 1:8633 W AIRPORT BLVD
Mailing Address - Street 2:103
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2479
Mailing Address - Country:US
Mailing Address - Phone:713-988-3900
Mailing Address - Fax:832-201-7872
Practice Address - Street 1:8633 W AIRPORT BLVD
Practice Address - Street 2:103
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2479
Practice Address - Country:US
Practice Address - Phone:713-988-3900
Practice Address - Fax:832-201-7872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty