Organization
A.M.E.N. HCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA J. CLEGG (PROGRAM MANAGER)
(361) 688-4734
Entity
Organization
Contact information
Practice address
1101 LOGAN AVE, CORPUS CHRISTI, TX 78404-3725
(361) 434-5107
(361) 334-3652
Mailing address
1101 LOGAN AVE, CORPUS CHRISTI, TX 78404-3725
(361) 434-5107
(361) 334-3652
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2500000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2500000
—
TX
Enumeration date
10/23/2012
Last updated
10/23/2012
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