Provider Demographics
NPI:1841619947
Name:KATHLEEN'S COMMUNITY, INC.
Entity Type:Organization
Organization Name:KATHLEEN'S COMMUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:713-729-6554
Mailing Address - Street 1:6318 SHERINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77085-3245
Mailing Address - Country:US
Mailing Address - Phone:713-729-6554
Mailing Address - Fax:
Practice Address - Street 1:6318 SHERINGHAM ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-3245
Practice Address - Country:US
Practice Address - Phone:713-729-6554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No305S00000XManaged Care OrganizationsPoint of Service