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Organization
LIFE GIVING LIFE THE RECOVERY PROJECT
Active
Organization
LIFE GIVING LIFE THE RECOVERY PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE MCKIBBEN CASE MANAGER (PEER SPECIALIST)
(512) 662-9041
Entity
Organization
Contact information
Practice address
14740 LIBERTY ST., MONTGOMERY, TX 77354-7735
(512) 662-9041
Mailing address
222 N VERSHIRE CIR, MAGNOLIA, TX 77354-3309
(512) 662-9041
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
261QR0400X
Rehabilitation Clinic/Center
—
NULL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
261QR0800X
Recovery Care Clinic/Center
—
NULL
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
NULL
3104A0625X
Assisted Living Facility (Mental Illness)
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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