Organization
HUNTSVILLE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACEY RAE HARRIS L.C.D.C. (CEO/PROGRAM SPONSOR)
(936) 524-2140
Entity
Organization
Contact information
Practice address
829 10TH ST, HUNTSVILLE, TX 77320-4721
(936) 291-9172
(936) 291-7156
Mailing address
829 10TH ST, HUNTSVILLE, TX 77320-4721
(936) 291-9172
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
TX10096M
TX
Other
Enumeration date
12/11/2007
Last updated
04/20/2012
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