Doctor Name: | MR. DONALD R ELLISON |
NPI Number: | 1396054961 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 14611 Chasemont Dr Missouri City, TX - 774891807 |
Business Phone Number: | 2814167487 |
Business Fax Number: | |
Mailing Address: | 14611 Chasemont Dr, MISSOURI CITY |
State: | TX |
Postal Code: | 774891807 |
Phone Number: | 2814167487 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2010 |
NPI Last Update Date: | 06/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |