Vintage Behavioral Services

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

VINTAGE BEHAVIORAL SERVICES

Practice address

6220 Westpark Dr Ste 149-B225
Houston, TX 77057-7371

Phone

(832) 788-6464

NPI assigned

Mar 15, 2024

Organization subpart

No

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

Authorized official

Name

Leslie Izekor

Title

Director

Phone

(832) 788-6464

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1487413241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 WESTPARK DR STE 149-B225",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770577371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 WESTPARK DR STE 149-B225",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770577371",
            "telephone_number": "832-788-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "IZEKOR",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "832-788-6464"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reshma Vinod
• Erica Leigh Vinogradov, FNP
• Devaughn Cornell Vinson, PTA
• Shannon Vinson
• Sherry Vinson, MD
• Vintage Healthcare, Inc.
• Vintage Modern Dentistry, PC
• Vintage Place Adult Day Care LLC
• Vintage Signature Home Health Agency LLC
• Kezia Vinu

• Case Management Agency in Houston, TX
• Providers in Houston, TX by specialty
• Case Management Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.