Provider Demographics
NPI:1871648816
Name:SOUTHWEST SOCIAL SVCES INC
Entity Type:Organization
Organization Name:SOUTHWEST SOCIAL SVCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REV
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:SR
Authorized Official - Credentials:QMHP CS REV
Authorized Official - Phone:832-878-2954
Mailing Address - Street 1:6722 ROWELL COURT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489
Mailing Address - Country:US
Mailing Address - Phone:832-878-7954
Mailing Address - Fax:
Practice Address - Street 1:14083 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035
Practice Address - Country:US
Practice Address - Phone:832-878-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care