Organization
LUBBOCK REGIONAL MHMR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY POPE (CEO)
(806) 766-0310
Entity
Organization
Contact information
Practice address
3105 29TH ST, LUBBOCK, TX 79410-3022
(806) 766-0310
(806) 744-9580
Mailing address
1602 10TH ST, LUBBOCK, TX 79401-2607
(806) 766-0310
(806) 744-9580
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
369701
ICFMR CONTRACT NUMBER
TX
Enumeration date
05/17/2007
Last updated
01/25/2008
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