Provider Demographics
NPI:1891907333
Name:LIFEBRANCH BEHAVIORAL HEALTH CARE SYSTEMS,INC.
Entity Type:Organization
Organization Name:LIFEBRANCH BEHAVIORAL HEALTH CARE SYSTEMS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-665-0837
Mailing Address - Street 1:2626 SOUTH LOOP WEST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2679
Mailing Address - Country:US
Mailing Address - Phone:713-665-0837
Mailing Address - Fax:713-665-0894
Practice Address - Street 1:2626 SOUTH LOOP WEST
Practice Address - Street 2:SUITE 118
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054
Practice Address - Country:US
Practice Address - Phone:713-665-0837
Practice Address - Fax:713-665-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)