Organization
CANYON LAKES RTC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LENISE STAHA (EXECUTIVE DIRECTOR)
(806) 762-5782
Entity
Organization
Contact information
Practice address
2402 CANYON LAKE DR, LUBBOCK, TX 79415-2000
(806) 762-5782
Mailing address
2402 CANYON LAKE DR, LUBBOCK, TX 79415-2000
(806) 762-5782
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
64653
TX
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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