Provider Demographics
NPI:1336380831
Name:E&A ENRICHMENT CENTER
Entity Type:Organization
Organization Name:E&A ENRICHMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PSHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-671-0414
Mailing Address - Street 1:10200 EAST FWY
Mailing Address - Street 2:SUITE# 145
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10200 EAST FWY
Practice Address - Street 2:SUITE# 145
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1920
Practice Address - Country:US
Practice Address - Phone:713-671-0414
Practice Address - Fax:713-671-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty