Organization
MALLARD LAKE RANCH DETOX CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI TAYLOR (CEO/OWNER)
(713) 444-0614
Entity
Organization
Contact information
Practice address
18407 HOPFE RD., HOCKLEY, TX 77447-7119
(936) 800-8025
(281) 781-2526
Mailing address
P.O. BOX 1104, HUMBLE, TX 77347-1104
(713) 444-0614
(281) 781-2526
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/08/2021
Last updated
02/22/2024
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