Provider Demographics
NPI:1447465505
Name:LYDIA J. WILLRICH
Entity type:Organization
Organization Name:LYDIA J. WILLRICH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HCS PROGRAM PROVIDER CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-741-6230
Mailing Address - Street 1:4838 WINFREE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2826
Mailing Address - Country:US
Mailing Address - Phone:713-741-6230
Mailing Address - Fax:713-741-8545
Practice Address - Street 1:4838 WINFREE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-2826
Practice Address - Country:US
Practice Address - Phone:713-741-6230
Practice Address - Fax:713-741-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities