Healthcare Provider Details

I. General information

NPI: 1629398367
Provider Name (Legal Business Name): TRI-COUNTY BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
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

Practice location:
  • Phone: 936-521-6100
  • Fax: 936-760-2898
Mailing address:
  • Phone: 936-521-6100
  • Fax: 936-760-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number3208-3209
License Number StateTX

VIII. Authorized Official

Name: EVAN ROBERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 936-521-6100