Provider Demographics
NPI:1093207649
Name:MOMENTUM BEHAVIORAL HEALTH CONCEPTS, LLC
Entity type:Organization
Organization Name:MOMENTUM BEHAVIORAL HEALTH CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYREETA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCUDDER-EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCDC, SAP
Authorized Official - Phone:832-865-4837
Mailing Address - Street 1:2719 BOUVARDIA WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1335
Mailing Address - Country:US
Mailing Address - Phone:832-865-4837
Mailing Address - Fax:
Practice Address - Street 1:2719 BOUVARDIA WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073
Practice Address - Country:US
Practice Address - Phone:832-865-4837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386249201Medicaid
TX386249202Medicaid