Provider Demographics
NPI:1821614769
Name:CARSON PARKE RESIDENTIAL TREATMENT CENTER
Entity Type:Organization
Organization Name:CARSON PARKE RESIDENTIAL TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:832-308-8069
Mailing Address - Street 1:262 N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-2027
Mailing Address - Country:US
Mailing Address - Phone:832-308-8069
Mailing Address - Fax:
Practice Address - Street 1:262 N SAM HOUSTON PKWY E FL 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-2027
Practice Address - Country:US
Practice Address - Phone:832-308-8069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty