Provider Demographics
NPI:1720160286
Name:CHRISBORN INC
Entity Type:Organization
Organization Name:CHRISBORN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OSI
Authorized Official - Middle Name:
Authorized Official - Last Name:NWADIEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-725-4768
Mailing Address - Street 1:10623 UMBER CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 SUGAR GROVE BLVD
Practice Address - Street 2:SUITE 290
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2635
Practice Address - Country:US
Practice Address - Phone:281-207-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities