Provider Demographics
NPI:1750719266
Name:SUBURBAN OUTLOOK FOR RECOVERY & ACADEMIC EXCHANGE INC.
Entity type:Organization
Organization Name:SUBURBAN OUTLOOK FOR RECOVERY & ACADEMIC EXCHANGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGING EMPLOYEE
Authorized Official - Prefix:MS
Authorized Official - First Name:ROZELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-257-1140
Mailing Address - Street 1:7312 LOUETTA RD STE B118
Mailing Address - Street 2:#109
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6176
Mailing Address - Country:US
Mailing Address - Phone:832-257-1140
Mailing Address - Fax:832-203-6387
Practice Address - Street 1:7903 OXFORDSHIRE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4669
Practice Address - Country:US
Practice Address - Phone:832-257-1140
Practice Address - Fax:832-203-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care