Organization
TRI-COUNTY BEHAVIORAL HEALTHCARE
Active
Other names
Holly Street House
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN ROBERSON (EXECUTIVE DIRECTOR)
(936) 521-6100
Entity
Organization
Contact information
Practice address
1420 HOLLY ST, LIBERTY, TX 77575-3118
(936) 521-6100
Mailing address
PO BOX 3067, CONROE, TX 77305-3067
(936) 521-6100
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000756601
—
TX
Enumeration date
07/21/2006
Last updated
06/27/2024
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