Organization
AWAKENINGS BYBEE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRODY SMITH (MANAGER)
(806) 669-7976
Entity
Organization
Contact information
Practice address
14355 N BYBEE LAKE CT, PORTLAND, OR 97203-6495
(806) 669-7976
Mailing address
1211 N PRICE RD, PAMPA, TX 79065-5909
(806) 669-7976
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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