Organization
BANYAN TEXAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SORY (CEO)
(954) 533-7705
Entity
Organization
Contact information
Practice address
4168 COUNTY ROAD 444, WAELDER, TX 78959-5328
(830) 283-3003
(830) 522-2003
Mailing address
225 N FEDERAL HWY, POMPANO BEACH, FL 33062-4319
(954) 781-7173
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4238503
—
TX
Enumeration date
08/13/2020
Last updated
05/13/2025
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