Provider Demographics
NPI:1750527370
Name:IMAR ENTERPRISES INC
Entity type:Organization
Organization Name:IMAR ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKMON-IMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-265-8967
Mailing Address - Street 1:4319 CANADIAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5401
Mailing Address - Country:US
Mailing Address - Phone:281-265-8967
Mailing Address - Fax:281-265-7032
Practice Address - Street 1:4319 CANADIAN RIVER DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5401
Practice Address - Country:US
Practice Address - Phone:281-265-8967
Practice Address - Fax:281-265-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health