Provider Demographics
NPI:1437485521
Name:MALLEY, LLC
Entity type:Organization
Organization Name:MALLEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNIOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-492-5275
Mailing Address - Street 1:2130 WHITE EAGLE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8689
Mailing Address - Country:US
Mailing Address - Phone:281-395-5540
Mailing Address - Fax:
Practice Address - Street 1:16350 PARK TEN PL STE 222
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5196
Practice Address - Country:US
Practice Address - Phone:281-994-4067
Practice Address - Fax:832-321-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty