Organization
TAMARACK RESIDENTIAL SERVICES
Active
Other names
Beverly
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE HAWKER II (CFO)
(210) 340-7155
Entity
Organization
Contact information
Practice address
3730 E LOOP DR, LONGVIEW, TX 75602-6704
(903) 753-1979
(903) 753-7485
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 340-7155
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
007599
TX
Other
Enumeration date
04/20/2006
Last updated
08/22/2020
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