Organization
HENRY DAVID HARDT PH D
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY DAVID HARDT PH.D. (OWNER/DIRECTOR)
(254) 776-0400
Entity
Organization
Contact information
Practice address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
(254) 776-0637
Mailing address
4555 LAKE SHORE DR, WACO, TX 76710-1814
(254) 776-0400
(254) 776-0637
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
220734
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
3581-3582
TX
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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