Provider Demographics
NPI:1609753367
Name:INCLUSIVE RESIDENTIAL TREATMENT CENTER
Entity type:Organization
Organization Name:INCLUSIVE RESIDENTIAL TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-451-9293
Mailing Address - Street 1:5407 MASONGLEN CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8817
Mailing Address - Country:US
Mailing Address - Phone:503-451-9293
Mailing Address - Fax:
Practice Address - Street 1:5407 MASONGLEN CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8817
Practice Address - Country:US
Practice Address - Phone:503-451-9293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health