Organization
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL THOMPSON (EXECUTIVE DIRECTOR)
(254) 752-3451
Entity
Organization
Contact information
Practice address
612 PARKSIDE DR, GROESBECK, TX 76642-1125
(254) 729-8177
(254) 729-8176
Mailing address
110 S 12TH ST, P O BOX 890, WACO, TX 76701-1810
(254) 752-3451
(254) 752-7421
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000713401
VENDOR #
TX
Enumeration date
10/13/2006
Last updated
03/05/2020
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