Provider Demographics
NPI:1134731391
Name:TEEN AND FAMILY SERVICES
Entity type:Organization
Organization Name:TEEN AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:713-464-3950
Mailing Address - Street 1:9337B KATY FWY STE 314
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1515
Mailing Address - Country:US
Mailing Address - Phone:713-464-3950
Mailing Address - Fax:
Practice Address - Street 1:11140 GREENBAY ST
Practice Address - Street 2:ANNEX
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6729
Practice Address - Country:US
Practice Address - Phone:713-464-3950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health