Provider Demographics
NPI:1477820058
Name:BOJE, LARRY
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:
Last Name:BOJE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:SUITE 530
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:281-660-6991
Mailing Address - Fax:
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:SUITE 530
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:281-660-6991
Practice Address - Fax:713-271-5353
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities