Provider Demographics
NPI:1417371683
Name:LASHA RENA HARRIS
Entity type:Organization
Organization Name:LASHA RENA HARRIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:281-571-1699
Mailing Address - Street 1:525 N SAM HOUSTON PKWY E STE 360H
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4017
Mailing Address - Country:US
Mailing Address - Phone:281-571-1699
Mailing Address - Fax:888-523-0960
Practice Address - Street 1:525 N SAM HOUSTON PKWY E STE 360H
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4017
Practice Address - Country:US
Practice Address - Phone:281-571-1699
Practice Address - Fax:888-523-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-09
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
TX251E00000X253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care