Organization
SABINE VALLEY REGIONAL MHMR CENTER
Active
Other names
Early Childhood Intervention, Community Healthcore
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY O VILLARREAL (PROVIDER ENROLLMENT/CREDENTIALING)
(903) 234-4226
Entity
Organization
Contact information
Practice address
107 WOODBINE PL UNIT 775, LONGVIEW, TX 75601-2912
(903) 918-5806
(903) 295-5803
Mailing address
107 WOODBINE PL UNIT 775, LONGVIEW, TX 75601-2912
(903) 918-5806
(903) 295-5803
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137921605
—
TX
Enumeration date
04/18/2007
Last updated
09/23/2021
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