Provider Demographics
NPI:1972893576
Name:SOUTHEAST HCS INC
Entity Type:Organization
Organization Name:SOUTHEAST HCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KA-KQUANA
Authorized Official - Middle Name:TYVON
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-752-4544
Mailing Address - Street 1:950 FM 1959 RD APT 704
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-5457
Mailing Address - Country:US
Mailing Address - Phone:832-752-4544
Mailing Address - Fax:888-638-0616
Practice Address - Street 1:950 FM 1959 RD APT 704
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5457
Practice Address - Country:US
Practice Address - Phone:832-752-4544
Practice Address - Fax:888-638-0616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities