Provider Demographics
NPI:1831645712
Name:CORA B
Entity Type:Organization
Organization Name:CORA B
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-408-9428
Mailing Address - Street 1:3139 W. HOLCOMBE BLVD
Mailing Address - Street 2:#605
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3139 W HOLCOMBE BLVD
Practice Address - Street 2:#605
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1533
Practice Address - Country:US
Practice Address - Phone:281-408-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No286500000XHospitalsMilitary HospitalGroup - Single Specialty