Provider Demographics
NPI:1871850396
Name:THOMPSON HUMAN SERVICE GROUP INC,.
Entity Type:Organization
Organization Name:THOMPSON HUMAN SERVICE GROUP INC,.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-476-1256
Mailing Address - Street 1:2314 ELMGATE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-5210
Mailing Address - Country:US
Mailing Address - Phone:713-476-1256
Mailing Address - Fax:713-239-2260
Practice Address - Street 1:10900 STONELAKE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5795
Practice Address - Country:US
Practice Address - Phone:713-476-1256
Practice Address - Fax:713-239-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities