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General NPI Number Information
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NPI Number | 1326139171
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Entity Type | Organization
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Legal Business Name | THE SOUTH TEXAS CARPENTER'S HOUSE
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 2507 LEXINGTON RD
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City | BEEVILLE
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State | TX
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Zip | 78102-7013
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Country | US
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Telephone | 361-358-1470
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Fax | 361-354-5533
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Provider Business Mailing Address
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Address Line | 2507 LEXINGTON RD
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City | BEEVILLE
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State | TX
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Zip | 78102-7013
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Country | US
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Telephone | 361-358-1470
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Fax | 361-354-5533
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT GEORGE OUTTEN
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Credential | MS LCDC
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Telephone | 361-358-1470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10134
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License Number State | TX
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