Organization
THE GULF COAST CENTER
Active
Organization
THE GULF COAST CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK ELIZONDO (CFO)
(409) 763-2373
Entity
Organization
Contact information
Practice address
4444 W MAIN ST, LEAGUE CITY, TX 77573-1737
(409) 763-2373
(409) 978-2401
Mailing address
4444 W MAIN ST, LEAGUE CITY, TX 77573-1737
(409) 763-2373
(409) 978-2401
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001007322
HCS CONTRACT NUMBER
TX
Enumeration date
03/05/2007
Last updated
06/28/2024
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