# GULF BEND MHMR CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912976101
- **Authorized official:** MR. DONALD L POLZIN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (361) 575-0611

## Contact information

- **Practice address:** 6502 NURSERY DR, SUITE 100, VICTORIA, TX 77904-1178
- **Practice address phone:** (361) 575-0611
- **Practice address fax:** (361) 575-0626
- **Mailing address:** 6502 NURSERY DR, SUITE 100, VICTORIA, TX 77904-1178
- **Mailing address phone:** (361) 575-0611
- **Mailing address fax:** (361) 575-0626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 03/17/2006
- **Last updated:** 08/03/2010