Provider Demographics
NPI:1972736197
Name:HALCYON FOUNDATION OF HOUSTON
Entity type:Organization
Organization Name:HALCYON FOUNDATION OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BONTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-970-5781
Mailing Address - Street 1:13518 MOBILE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4418
Mailing Address - Country:US
Mailing Address - Phone:713-970-5781
Mailing Address - Fax:
Practice Address - Street 1:13518 MOBILE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-4418
Practice Address - Country:US
Practice Address - Phone:713-970-5781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility