Organization
MCET-LONGVIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT JACOBS (PROGRAM DIRECTOR)
(903) 520-4710
Entity
Organization
Contact information
Practice address
505 NORTH SIXTH STREET, LONGVIEW, TX 75602
(903) 520-4710
Mailing address
P. O. BOX 9958, LONGVIEW, TX 75608
(903) 520-4710
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
TX
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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