Healthcare Provider Details

I. General information

NPI: 1801940929
Provider Name (Legal Business Name): LAKES REGIONAL MHMR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AIRPORT RD
TERRELL TX
75160-4302
US

IV. Provider business mailing address

PO BOX 747
TERRELL TX
75160-0014
US

V. Phone/Fax

Practice location:
  • Phone: 972-388-2000
  • Fax: 972-388-2010
Mailing address:
  • Phone: 972-388-2000
  • Fax: 972-388-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number001010201
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number001010609
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001008029
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001012279
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001012280
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001012281
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001012282
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number001007185
License Number StateTX

VIII. Authorized Official

Name: ZANETTE COTTON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 972-524-4159