Provider Demographics
NPI:1023377280
Name:THOMPSON HUMAN SERVICE GROUP INC,.
Entity type:Organization
Organization Name:THOMPSON HUMAN SERVICE GROUP INC,.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-677-8511
Mailing Address - Street 1:2111 ROSEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:832-676-2369
Practice Address - Street 1:2111 ROSEFIELD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6438
Practice Address - Country:US
Practice Address - Phone:832-677-8511
Practice Address - Fax:832-676-2369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities