Provider Demographics
NPI:1972200251
Name:RUSSO CARE
Entity type:Organization
Organization Name:RUSSO CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-607-1370
Mailing Address - Street 1:PO BOX 1394
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-1394
Mailing Address - Country:US
Mailing Address - Phone:281-607-1370
Mailing Address - Fax:832-582-3647
Practice Address - Street 1:17302 HOUSE HAHL RD STE 207
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-8213
Practice Address - Country:US
Practice Address - Phone:281-607-1370
Practice Address - Fax:832-582-3647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health