Organization
CADWALDER BEHAVIORAL CLINICS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN D. INGRAM (ADMINISTRATOR)
(713) 227-8246
Entity
Organization
Contact information
Practice address
14030 CRESCENT DR, TOMBALL, TX 77375-4011
(281) 351-6644
(281) 351-1357
Mailing address
30903 QUINN RD, TOMBALL, TX 77375-2959
(281) 351-6644
(281) 351-1357
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
2307-A
TX
323P00000X
Psychiatric Residential Treatment Facility
2307-A
TX
324500000X
Substance Abuse Rehabilitation Facility
2307-A
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160975001
—
TX
Enumeration date
08/21/2006
Last updated
01/10/2011
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