Organization
CANYON LAKES RESIDENTIAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENISE L STAHA (EXECUTIVE DIRECTOR)
(806) 762-5782
Entity
Organization
Contact information
Practice address
2402 CANYON LAKES DR, LUBBOCK, TX 79415-2000
(806) 762-5782
(806) 762-0838
Mailing address
2402 CANYON LAKES DR, LUBBOCK, TX 79415-2000
(806) 762-5782
(806) 762-0838
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/02/2006
Last updated
08/22/2020
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