Provider Demographics
NPI:1851616841
Name:CORMFORT OF MIND SERVICES INC
Entity Type:Organization
Organization Name:CORMFORT OF MIND SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:DIRDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-582-7156
Mailing Address - Street 1:3203 BIRCH PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-3120
Mailing Address - Country:US
Mailing Address - Phone:713-582-7156
Mailing Address - Fax:
Practice Address - Street 1:3203 BIRCH PARK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-3120
Practice Address - Country:US
Practice Address - Phone:713-582-7156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health