Provider Demographics
NPI:1396250528
Name:DJR COMMUNITY HEALTH CLINIC
Entity type:Organization
Organization Name:DJR COMMUNITY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:GLYNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-539-1416
Mailing Address - Street 1:1937 TEXAS PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3121
Mailing Address - Country:US
Mailing Address - Phone:832-539-1416
Mailing Address - Fax:832-539-1478
Practice Address - Street 1:1937 TEXAS PKWY
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3121
Practice Address - Country:US
Practice Address - Phone:832-539-1416
Practice Address - Fax:832-539-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty