Zachary'S House, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

ZACHARY'S HOUSE, LLC

Practice address

3315 FM 523 Rd
Freeport, TX 77541-6616

Phone

(346) 287-8938

NPI assigned

Dec 9, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clifford Wayne Robertson Jr., LCCANPI 1518725522

Title

Licensed Childcare Administrator

Phone

(979) 203-6470

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clifford Wayne Robertson Jr.

  • Mental Health Counselor
  • Brenham, TX
  • NPI 1518725522
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1124834668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 FM 523 RD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775416616",
            "telephone_number": "346-287-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 FM 523 RD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775416616",
            "telephone_number": "346-287-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZACHARY'S HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "LICENSED CHILDCARE ADMINISTRATOR",
        "authorized_official_telephone_number": "979-203-6470",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCCA"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Jean Walker
• Teena N White
• Lakita F Williams, APRN-C
• Inyang E Wilson, PA
• Faith Elizabeth Worley, LCSW

• Emotionally Disturbed Childrens' Residential Treatment Facility in Freeport, TX
• Providers in Freeport, TX by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.