Organization
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL THOMPSON (EXECUTIVE DIRECTOR)
(254) 752-3451
Entity
Organization
Contact information
Practice address
1105 JEFFERSON AVE, WACO, TX 76701-1212
(254) 752-7889
(254) 752-7899
Mailing address
110 S 12TH ST, P O BOX 890, WACO, TX 76701-1810
(254) 752-3451
(254) 752-7421
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2007020591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111409202
—
TX
Enumeration date
10/24/2006
Last updated
03/05/2020
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