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General NPI Number Information
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NPI Number | 1508933987
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Entity Type | Organization
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Legal Business Name | ST. GILES - BAYTOWN, INC.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3010 S 1ST ST
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City | LUFKIN
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State | TX
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Zip | 75901-7110
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Country | US
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Telephone | 936-639-1600
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Fax | 936-639-1632
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Provider Business Mailing Address
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Address Line | 4800 OVERTON PLZ STE 440
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City | FORT WORTH
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State | TX
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Zip | 76109-4435
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Country | US
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Telephone | 800-299-5161
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Fax | 817-447-3033
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 001014227
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License Number State | TX
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