Provider Demographics
NPI:1255940722
Name:LAGRUE INC.
Entity type:Organization
Organization Name:LAGRUE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAGRUE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:832-364-9413
Mailing Address - Street 1:14565 MISTY MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3175
Mailing Address - Country:US
Mailing Address - Phone:832-364-9413
Mailing Address - Fax:832-369-7398
Practice Address - Street 1:888 W SAM HOUSTON PKWY S STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1991
Practice Address - Country:US
Practice Address - Phone:832-364-9413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAGRUE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-30
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty