Healthcare Provider Details
I. General information
NPI: 1750337465
Provider Name (Legal Business Name): TRI-COUNTY BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
233 SGT ED HOLCOMB BLVD S
CONROE TX
77304-1990
US
IV. Provider business mailing address
PO BOX 3067
CONROE TX
77305-3067
US
V. Phone/Fax
- Phone: 936-521-6100
- Fax: 936-760-2898
- Phone: 936-521-6100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EVAN
ROBERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 936-521-6100