Provider Demographics
NPI:1649473356
Name:ANESSA COMMUNITY SERVICE
Entity type:Organization
Organization Name:ANESSA COMMUNITY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:GREENRIDGE
Authorized Official - Last Name:EMAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-668-9595
Mailing Address - Street 1:1610 BLODGETT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5017
Mailing Address - Country:US
Mailing Address - Phone:713-668-9595
Mailing Address - Fax:713-668-9590
Practice Address - Street 1:1610 BLODGETT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5017
Practice Address - Country:US
Practice Address - Phone:713-668-9595
Practice Address - Fax:713-668-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health