Provider Demographics
NPI:1992877948
Name:SHILOH TREATMENT CENTER, INC.
Entity type:Organization
Organization Name:SHILOH TREATMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-489-1290
Mailing Address - Street 1:PO BOX 84469
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0011
Mailing Address - Country:US
Mailing Address - Phone:281-489-1290
Mailing Address - Fax:281-489-8806
Practice Address - Street 1:4774 DEL BELLO RD
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578
Practice Address - Country:US
Practice Address - Phone:281-489-1290
Practice Address - Fax:281-489-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TXTDFPS517689323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty