Provider Demographics
NPI:1790900017
Name:XSCAPE
Entity Type:Organization
Organization Name:XSCAPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-665-1166
Mailing Address - Street 1:5959 WEST LOOP S
Mailing Address - Street 2:SUITE 440
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2421
Mailing Address - Country:US
Mailing Address - Phone:713-665-1166
Mailing Address - Fax:
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:SUITE 440
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:713-665-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty