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RESURGENCE TEXAS NPI 1124627443


NPI Information

NPI: 1124627443
Provider Name: RESURGENCE TEXAS
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 45D2221071

Address:
10703 RANCH ROAD 12
WIMBERLEY, TX
ZIP 78676
Phone: (888) 700-5053
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RESURGENCE TEXAS is a substance abuse rehabilitation facility in Wimberley, TX. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RESURGENCE TEXAS NPI is 1124627443. The provider is registered as an organization entity type.

The provider's business location address is:

10703 RANCH ROAD 12
WIMBERLEY, TX
ZIP 78676-239
Phone: (888) 700-5053
Fax: (949) 209-5490

The provider's authorized official is Jamie Littleton .
The authorized official title is National Clinical Director and has the following contact phone number (949) 244-5481.

The CLIA number assigned to this NPI record is 45D2221071 - other - substance abuse treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2020 and was last updated on 4/19/2022.


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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
2324500000XSubstance Abuse Rehabilitation FacilityYes

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

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