RUSSIAN COMMUNITY SERVICES,INC , NPI 1588658454 — HOUSTON (TX)

NPI 1588658454

14+ Years Experience Organization

RUSSIAN COMMUNITY SERVICES,INC

09.07.2005
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1588658454
NPI NUMBER

About RUSSIAN COMMUNITY SERVICES,INC

RUSSIAN COMMUNITY SERVICES,INC is a provider established in HOUSTON, TX. The NPI number of RUSSIAN COMMUNITY SERVICES,INC is 1588658454 and was assigned on 09.07.2005. The practitioners primary taxonomy code is: 261QA0600X with license number: 113568 TX .

Mailing address

  • City: BELLAIRE
  • State: TX
  • Postal code: 774020606
  • Phone: 7137780520
  • Fax: 7137721810
  • Address: PO BOX 606

Primary Practice Address

  • Region : HOUSTON, TX
  • NPI : 1588658454
  • Phone : 7137780520
  • Postalcode : 770747203
  • Address : 6410 INDIGO ST

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QA0600X
  • License number: 113568
  • License state: TX

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • RUSSIAN COMMUNITY SERVICES,INC
  • Address : 6410 INDIGO ST
  • Region : HOUSTON, TX
  • NPI : 1588658454
  • Phone : 7137780520
  • Postalcode : 770747203

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 7137780520
  • Title or position : ADMINISTRATOR

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address6410 INDIGO ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameHOUSTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code770747203
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7137780520
The telephone number associated with the location address of the provider being identified.
NPI1588658454
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QA0600X
Provider Enumeration Date09.07.2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)RUSSIAN COMMUNITY SERVICES,INC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 606
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameBELLAIRE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code774020606
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7137780520
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number7137721810
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameKISLYUK
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameSVETLANA
The first name of the authorized official
Authorized Official Title or PositionADMINISTRATOR
The title or position of the authorized official
Authorized Official Name Prefix TextMRS.
Authorized Official Name Prefix Text
Authorized Official Telephone Number7137780520
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QA0600X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number 1113568
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1TX
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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