Provider Demographics
NPI:1982985560
Name:PARK PLACE HCS
Entity Type:Organization
Organization Name:PARK PLACE HCS
Other - Org Name:PARK PLACE HCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHALLA
Authorized Official - Middle Name:DENINE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-472-4488
Mailing Address - Street 1:12802 SCHILLER PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1953
Mailing Address - Country:US
Mailing Address - Phone:832-472-4488
Mailing Address - Fax:
Practice Address - Street 1:12802 SCHILLER PARK LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1953
Practice Address - Country:US
Practice Address - Phone:832-472-4488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities