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General NPI Number Information
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NPI Number | 1487977716
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Entity Type | Organization
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Legal Business Name | WILLIAM BEAUMONT ARMY MEDICAL CENTER-ARMY SUBSTANCE ABUSE PROGRAM
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 1512 MATHIAS
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City | EL PASO
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State | TX
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Zip | 79903
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Country | US
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Telephone | 915-569-3601
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 MATHIAS
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City | EL PASO
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State | TX
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Zip | 79903
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Country | US
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Telephone | 915-569-3601
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. ELIZABETH AGUILERA
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Credential | LMSW, CADC I
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Telephone | 915-569-3601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 52708
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | KS
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