Organization
G AND T YOUNG AT HEART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA JONES (CEO)
(903) 236-5054
Entity
Organization
Contact information
Practice address
1012 E COTTON ST, LONGVIEW, TX 75602-1322
(903) 236-5054
Mailing address
PO BOX 5482, LONGVIEW, TX 75608-5482
(903) 236-5054
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/17/2019
Last updated
02/17/2019
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