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General NPI Number Information
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NPI Number | 1235598806
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Entity Type | Organization
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Legal Business Name | SABINE VALLEY REGIONAL MHMR CENTER
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3110 H G MOSLEY PKWY STE 104
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City | LONGVIEW
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State | TX
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Zip | 75605-2941
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Country | US
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Telephone | 903-234-9200
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Fax | 903-234-1639
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Provider Business Mailing Address
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Address Line | PO BOX 6800
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City | LONGVIEW
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State | TX
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Zip | 75608-6800
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Country | US
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Telephone | 903-758-2471
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ROSEMARY O VILLARREAL
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Credential | PESC
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Telephone | 903-234-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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