Provider Demographics
NPI:1427719400
Name:SIVAD HOME AND COMMUNITY SERVICES OF TEXAS LLC
Entity type:Organization
Organization Name:SIVAD HOME AND COMMUNITY SERVICES OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-400-3448
Mailing Address - Street 1:1799 STUMPF BLVD # 7-2A
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-400-3448
Mailing Address - Fax:504-617-7778
Practice Address - Street 1:700 W CENTER ST APT 171
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4549
Practice Address - Country:US
Practice Address - Phone:504-400-3448
Practice Address - Fax:504-617-7778
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIVAD HOME AND COMMUNITY SERVICES OF TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health