Provider Demographics
NPI:1801124706
Name:FRIAS AFTER SCHOOL PROGRAM
Entity type:Organization
Organization Name:FRIAS AFTER SCHOOL PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-202-6419
Mailing Address - Street 1:20215 APACHE GARDENS LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3215
Mailing Address - Country:US
Mailing Address - Phone:832-202-6419
Mailing Address - Fax:
Practice Address - Street 1:20215 APACHE GARDENS LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-3215
Practice Address - Country:US
Practice Address - Phone:832-202-6419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty