106BH LLC
Organization Active NPI Case Management Agency · Houston, TX
NPI 1972384469 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1972384469
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- Legal business name
- 106BH LLC
- Practice address
- 1034 Regional Park Dr
Houston, TX 77060-1117 - Phone
- (346) 842-0424
- NPI assigned
- Oct 10, 2023
- Organization subpart
- No
Authorized official
- Name
- Jon Nathan Ford
- Title
- Manager
- Phone
- (346) 842-0424
Practitioners 4
-
Letitia Shanell Powell, MA, LPC-S, PHD
-
Miles S Raizada, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240205002451 | TX | Part B Supplier - Clinic/Group Practice | 7911340120 |
Receives reassigned benefits from 4 practitioners Practice locations: Houston, TX; Jefferson, TX; Humble, TX; Balch Springs, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
1034 Regional Park Dr
Houston, TX 77060-1117
Mailing address
1034 Regional Park Dr
Houston, TX 77060-1117
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.