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General NPI Number Information
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NPI Number | 1033579651
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Entity Type | Organization
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Legal Business Name | UCG CENTRAL TEXAS HOLDINGS LLC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 5003 14TH ST
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City | LUBBOCK
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State | TX
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Zip | 79416-5615
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Country | US
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Telephone | 682-707-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 N WHEELER ST
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City | VICTORIA
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State | TX
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Zip | 77901-4849
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Country | US
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Telephone | 361-575-1558
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Fax |
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Authorized Official
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Title or Position | LICENSING COORDINATOR
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Name | BRANDI TURNER
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Credential |
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Telephone | 682-707-2756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | TX
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