Provider Demographics
NPI:1710505250
Name:ERG HEALTH AND WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:ERG HEALTH AND WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRADNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-298-6654
Mailing Address - Street 1:21107 SOMERVELL CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7167
Mailing Address - Country:US
Mailing Address - Phone:713-298-6654
Mailing Address - Fax:
Practice Address - Street 1:21107 SOMERVELL CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7167
Practice Address - Country:US
Practice Address - Phone:713-298-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services