Distinctive Differences

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

DISTINCTIVE DIFFERENCES

Practice address

3514 Lydia St
Houston, TX 77021-5914

Phone

(281) 743-1583

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Cicely Gibson

Title

Owner

Phone

(281) 743-1583

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1780937714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330467",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772330467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 LYDIA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770215914",
            "telephone_number": "281-743-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE DIFFERENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CICELY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-743-1583"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Houston, TX
• Providers in Houston, TX by specialty
• Assisted Living Facility (Mental Illness) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.