Provider Demographics
NPI:1912229519
Name:ASSET BUILDING NETWORK, INC.
Entity Type:Organization
Organization Name:ASSET BUILDING NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:UDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-776-3925
Mailing Address - Street 1:P.O. BOX 711212
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-1212
Mailing Address - Country:US
Mailing Address - Phone:713-776-3925
Mailing Address - Fax:713-271-7215
Practice Address - Street 1:9888 BISSONNET
Practice Address - Street 2:SUITE 242
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8248
Practice Address - Country:US
Practice Address - Phone:713-776-3925
Practice Address - Fax:713-271-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320800000X
320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid