Provider Demographics
NPI:1124882188
Name:MARBLE BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:MARBLE BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:IZEKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-429-8660
Mailing Address - Street 1:3050 POST OAK BLVD STE 510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6512
Mailing Address - Country:US
Mailing Address - Phone:713-429-8660
Mailing Address - Fax:713-429-8661
Practice Address - Street 1:3050 POST OAK BLVD STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6512
Practice Address - Country:US
Practice Address - Phone:713-429-8660
Practice Address - Fax:713-429-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty