Provider Demographics
| NPI: | 1801354626 |
|---|---|
| Name: | MATERNAL CHILD NETWORK LLC |
| Entity type: | Organization |
| Organization Name: | MATERNAL CHILD NETWORK LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JACQUELINE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ROWSER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 832-886-7662 |
| Mailing Address - Street 1: | 307 N SAN JACINTO ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CONROE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77301-2845 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-396-3449 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1526 KATY GAP RD STE 501 |
| Practice Address - Street 2: | |
| Practice Address - City: | KATY |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77494-6523 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-396-3449 |
| Practice Address - Fax: | 832-553-2842 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2019-03-11 |
| Last Update Date: | 2024-09-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251B00000X | Agencies | Case Management | ||
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Single Specialty |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | ||
| No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 251E00000X | Agencies | Home Health | ||
| No | 251S00000X | Agencies | Community/Behavioral Health |
