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General NPI Number Information
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NPI Number | 1396951034
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Entity Type | Organization
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Legal Business Name | MID-TEXAS COUNCIL ON ALCOHOL AND DRUG ABUSE
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 901 AVENUE B
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City | BROWNWOOD
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State | TX
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Zip | 76801-3313
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Country | US
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Telephone | 325-646-8747
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Fax | 325-643-3512
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Provider Business Mailing Address
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Address Line | 901 AVENUE B
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City | BROWNWOOD
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State | TX
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Zip | 76801-3313
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Country | US
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Telephone | 325-646-8747
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Fax | 325-643-3512
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Authorized Official
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Title or Position | ADMIN. ASST.
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Name | CAROL TAYLOR
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Credential |
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Telephone | 325-646-8747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 1641A
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 1641
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License Number State | TX
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