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CLEARFORK CLEBURNE LLC NPI 1821755471


NPI Information

NPI: 1821755471
Provider Name: CLEARFORK CLEBURNE LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 45D2132378

Address:
1632 E FM 4
CLEBURNE, TX
ZIP 76031
Phone: (817) 259-2597
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CLEARFORK CLEBURNE LLC is a substance abuse rehabilitation facility in Cleburne, 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. CLEARFORK CLEBURNE LLC NPI is 1821755471. The provider is registered as an organization entity type.

The provider's business location address is:

1632 E FM 4
CLEBURNE, TX
ZIP 76031-861
Phone: (817) 259-2597
Fax: (817) 977-9507

The provider's authorized official is Austin Dale Davis .
The authorized official title is Ceo and has the following contact phone number (817) 714-1311.

The CLIA number assigned to this NPI record is 45D2132378 - other - residential subs with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2021 and was last updated on 11/18/2021.


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
1324500000XSubstance 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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