Organization
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL THOMPSON (DATA ADMIN)
(254) 752-3451
Entity
Organization
Contact information
Practice address
1105 JEFFERSON AVE, WACO, TX 76701-1212
(254) 752-7889
(254) 756-3133
Mailing address
1105 JEFFERSON AVE, WACO, TX 76701-1212
(254) 752-7889
(254) 756-3133
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08485902
—
TX
Enumeration date
09/08/2015
Last updated
03/05/2020
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