Provider Demographics
NPI:1528512498
Name:ZAXON HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:ZAXON HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIDUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-330-6049
Mailing Address - Street 1:7307 CRESCENT BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1686
Mailing Address - Country:US
Mailing Address - Phone:832-330-6049
Mailing Address - Fax:832-205-8007
Practice Address - Street 1:7307 CRESCENT BRIDGE CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1686
Practice Address - Country:US
Practice Address - Phone:832-330-6049
Practice Address - Fax:832-205-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities