Organization
INITIATIVE CARE GROUP HCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER AGBORTOKO (DIRECTOR OF SERVICES)
(346) 240-0108
Entity
Organization
Contact information
Practice address
730 ADAMS ST, BEAUMONT, TX 77705-4126
(346) 240-0108
Mailing address
730 ADAMS ST, BEAUMONT, TX 77705-4126
(346) 240-0108
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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