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General NPI Number Information
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NPI Number | 1528420171
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Entity Type | Organization
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Legal Business Name | WAYMAKER TX, LLC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 608 BRIARWILDE CT
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City | ALVIN
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State | TX
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Zip | 77511-3623
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Country | US
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Telephone | 281-692-2179
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 743
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City | MANVEL
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State | TX
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Zip | 77578-0743
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Country | US
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Telephone | 281-692-2179
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Fax | 832-201-7898
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Authorized Official
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Title or Position | CLINICAL TREATMENT DIRECTOR
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Name | TIFFANY DENISE TOUSANT
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Credential | LPC
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Telephone | 281-692-2179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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