Organization
T-FORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLOTA AGUILAR-LONG MA , CCJP (DIRECTOR)
(409) 789-4892
Entity
Organization
Contact information
Practice address
660 WARSAW ST, BAYOU VISTA, TX 77563-2606
(409) 789-4892
(831) 305-9133
Mailing address
660 WARSAW ST, BAYOU VISTA, TX 77563-2606
(409) 789-4892
(831) 305-9133
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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