Provider Demographics
NPI:1942465372
Name:ALL FOR YOUTH REHAB. CTR. INC.
Entity Type:Organization
Organization Name:ALL FOR YOUTH REHAB. CTR. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-866-6505
Mailing Address - Street 1:7100 REGENCY SQUARE SQ
Mailing Address - Street 2:STE 103B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-5807
Mailing Address - Country:US
Mailing Address - Phone:713-866-6505
Mailing Address - Fax:
Practice Address - Street 1:7100 REGENCY SQ STE
Practice Address - Street 2:103B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-5807
Practice Address - Country:US
Practice Address - Phone:713-866-6505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19337101Y00000X
TX20306101Y00000X
TX227177163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170558401Medicaid