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Organization

BORDER REGION MHMR YOUTH EMPOWERMENT SERVICES WAIVER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL G CASTILLON (EXECTIVE DIRECTOR)
(956) 794-3000
Entity
Organization

Contact information

Practice address
1500 PAPPAS ST, LAREDO, TX 78041-1701
(956) 794-3000
(956) 794-3325
Mailing address
1500 PAPPAS ST, LAREDO, TX 78041-1701
(956) 794-3000
(956) 794-3325

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121989103
TX
Enumeration date
10/16/2015
Last updated
10/16/2015
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