Organization
BORDER REGION MHMR COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUPERTO ROLANDO GUTIERREZ (CHIEF FINANCIAL OFFICIER)
(956) 794-3010
Entity
Organization
Contact information
Practice address
1500 PAPPAS ST, LAREDO, TX 78041-1701
(956) 794-3000
Mailing address
PO BOX 1835, LAREDO, TX 78044-1835
(956) 794-3000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121989101
—
TX
05
—
121989102
—
TX
Enumeration date
12/07/2007
Last updated
11/01/2022
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