Provider Demographics
NPI:1174287718
Name:ACCLAIM BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:ACCLAIM BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NDULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-409-0129
Mailing Address - Street 1:14917 RICHMOND AVE APT 411
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1545
Mailing Address - Country:US
Mailing Address - Phone:346-400-8133
Mailing Address - Fax:
Practice Address - Street 1:14917 RICHMOND AVE APT 411
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1545
Practice Address - Country:US
Practice Address - Phone:346-400-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management