Organization
COASTAL PLAINS COMMUNITY MHMR CENTER
Active
Other names
Coastal Plains Community Center
Organization subpart
No
Provider details
NPI number
Authorized official
LEONEL TREJO (CHIEF EXECUTIVE OFFICER)
(361) 777-3991
Entity
Organization
Contact information
Practice address
200 MARRIOTT DR, PORTLAND, TX 78374-2213
(361) 777-3991
(361) 777-0610
Mailing address
200 MARRIOTT DR, PORTLAND, TX 78374-2213
(361) 777-3991
(361) 777-0610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126843505
—
TX
Enumeration date
03/06/2007
Last updated
11/18/2024
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