Organization
LAKES REGIONAL MHMR CENTER
Active
Organization
LAKES REGIONAL MHMR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DELANEY (EXECUTIVE DIRECTOR)
(972) 524-4159
Entity
Organization
Contact information
Practice address
4804 WESLEY ST, GREENVILLE, TX 75401-5650
(903) 454-0300
(903) 454-8635
Mailing address
400 AIRPORT RD, TERRELL, TX 75160-4302
(972) 524-4159
(972) 563-0292
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
103098
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103098
PROFESSIONAL LICENSE NUMB
TX
Enumeration date
02/11/2008
Last updated
02/11/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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