Organization
BEHAVIORAL HOSPITAL OF LONGVIEW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK J HARRIS (MANAGING MEMBER)
(337) 264-8121
Entity
Organization
Contact information
Practice address
22 BERMUDA LN, LONGVIEW, TX 75605-2902
(903) 291-3456
Mailing address
2014 W PINHOOK RD, SUITE 610, LAFAYETTE, LA 70508-8504
(337) 264-8121
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
008387
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
454105
MEDICARE PROVIDER NUMBER
TX
Enumeration date
01/02/2008
Last updated
04/09/2008
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