Organization
CITY OF LAREDO
Active
Parent organization
CITY OF LAREDO
Other names
ROOTS Recovery Center, City of Laredo Detox Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF LAREDO
Authorized official
DR. SAN JUANA VIVIANA MARTINEZ PH.D., DHA, LCDC (DETOXIFICATION DIRECTOR)
(956) 679-2826
Entity
Organization
Contact information
Practice address
1300 CHICAGO ST., SUITE 101, LAREDO, TX 78040
(956) 679-2826
Mailing address
1300 CHICAGO ST., SUITE 101, LAREDO, TX 78040
(956) 679-2826
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
06/12/2024
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