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Organization
NORTHEAST TEXAS MENTAL HEALTH MENTAL RETARDATION CENTER
Active
Organization
NORTHEAST TEXAS MENTAL HEALTH MENTAL RETARDATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY FREEMAN (ADMINISTRATIVE & FINANCE DIRECTOR)
(903) 831-3646
Entity
Organization
Contact information
Practice address
1 C OAKLAWN CENTER, TEXARKANA, TX 75501-4159
(903) 831-7585
(903) 831-4823
Mailing address
PO BOX 5637, TEXARKANA, TX 75505-5637
(903) 831-7585
(903) 831-4823
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PM39
BLUECROSSBLUESHIELD
TX
Enumeration date
06/09/2006
Last updated
08/22/2020
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