Healthcare Provider Details

I. General information

NPI: 1932219821
Provider Name (Legal Business Name): TRI-COUNTY COUNTY BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TRI-COUNTY BEHAVIORAL HEALTHCARE 233 SGT ED HOLCOMB BLVD S
CONROE TX
77304-1990
US

IV. Provider business mailing address

PO BOX 3067
CONROE TX
77305
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 Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

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