Provider Demographics
NPI:1801049622
Name:WOMEN OF HONOR AND DESTINY, TLC, INC.
Entity type:Organization
Organization Name:WOMEN OF HONOR AND DESTINY, TLC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FREEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-516-3831
Mailing Address - Street 1:25002 IBERIS MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5612
Mailing Address - Country:US
Mailing Address - Phone:281-516-3831
Mailing Address - Fax:281-516-7716
Practice Address - Street 1:25002 IBERIS MEADOWS DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5612
Practice Address - Country:US
Practice Address - Phone:281-516-3831
Practice Address - Fax:281-516-7716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183189301Medicaid