Provider Demographics
NPI:1831237346
Name:POSITIVE HEALTH MANAGEMENT
Entity type:Organization
Organization Name:POSITIVE HEALTH MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-241-7600
Mailing Address - Street 1:4101 HIGHWAY 77
Mailing Address - Street 2:UNIT G
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-4542
Mailing Address - Country:US
Mailing Address - Phone:361-241-7600
Mailing Address - Fax:361-241-7613
Practice Address - Street 1:4101 HIGHWAY 77
Practice Address - Street 2:SUITE G
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4542
Practice Address - Country:US
Practice Address - Phone:361-241-7600
Practice Address - Fax:361-241-7613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33490103T00000X
TX261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)