COASTAL PLAINS COMMUNITY MHMR NPI 1114057700

NPI Information

NPI: 1114057700
Provider Name: COASTAL PLAINS COMMUNITY MHMR

Doing Business As: COASTAL PLAINS COMMUNITY CENTER

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
200 MARRIOTT DR
PORTLAND, TX
ZIP 78374
Phone: (361) 777-3991
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COASTAL PLAINS COMMUNITY MHMR is a mental health counselor in Portland, TX. COASTAL PLAINS COMMUNITY MHMR NPI is 1114057700. The provider is registered as an organization entity type.
The provider Is Doing Business As Coastal Plains Community Center.

The provider's business location address is:

200 MARRIOTT DR
PORTLAND, TX
ZIP 78374-213
Phone: (361) 777-3991
Fax: (361) 777-0610

The provider's authorized official is Leonel Trejo .
The authorized official title is Chief Executive Officer and has the following contact phone number (361) 777-3991.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 6/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	126843505	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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