Provider Demographics
NPI:1538828926
Name:COLVIN, CHARITY A (CEO/PROGRAM DIRECTOR)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:A
Last Name:COLVIN
Suffix:
Gender:F
Credentials:CEO/PROGRAM DIRECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12436 FM 1960 RD W # 339
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4809
Mailing Address - Country:US
Mailing Address - Phone:800-785-6618
Mailing Address - Fax:800-785-6618
Practice Address - Street 1:8301 WILLOW PLACE DR N APT 1115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5664
Practice Address - Country:US
Practice Address - Phone:800-785-6618
Practice Address - Fax:800-785-6618
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide