Organization
PADRE BEHAVIORAL HEALTH SYSTEM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SEWELL CROLEY (CEO-CFO)
(361) 986-9444
Entity
Organization
Contact information
Practice address
6629 WOOLDRIDGE RD, CORPUS CHRISTI, TX 78414-2909
(361) 986-9444
(361) 986-1897
Mailing address
6629 WOOLDRIDGE RD, CORPUS CHRISTI, TX 78414-2909
(361) 986-9444
(361) 986-1897
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
007165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH0978
BCBS PSYCH
TX
01
—
HH3978
BCBS CD
TX
01
—
HH6788
BCBS PARTIAL
TX
Enumeration date
06/30/2005
Last updated
08/22/2020
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