Organization
CONCHO VALLEY CENTER FOR HUMAN ADVANCEMENT
Active
Other names
MHMR Services for the Concho Valley
Organization subpart
No
Provider details
NPI number
Authorized official
ALTON TODD BAIRD (IT DIRECTOR/CREDENTIALING SPECIALIS)
(325) 658-7750
Entity
Organization
Contact information
Practice address
424 S OAKES ST, SAN ANGELO, TX 76903-5944
(325) 658-7750
Mailing address
1501 W BEAUREGARD AVE, SAN ANGELO, TX 76901-4004
(325) 658-7750
(325) 658-8381
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109483102
—
TX
05
—
127323701
—
TX
05
—
127323702
—
TX
05
—
127323704
—
TX
Enumeration date
02/07/2007
Last updated
05/04/2026
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