Organization
BRAZOS INTENSIVE OUTPATIENT PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN PATTERSON (CEO)
(254) 775-4088
Entity
Organization
Contact information
Practice address
257 FM 927 CR, MORGAN, TX 76671-1111
(254) 775-4088
(267) 795-9510
Mailing address
1114 LOST CREEK BLVD, STE 500, AUSTIN, TX 78746-6300
(512) 308-6032
(512) 306-9188
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
3593-3594
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3593-3594
FACILITY LICENSE NUMBER
TX
Enumeration date
02/07/2013
Last updated
03/18/2013
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