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General NPI Number Information
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NPI Number | 1548298151
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Entity Type | Organization
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Legal Business Name | CEE-BREEZE SILMHR, LLC.
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1610 KILDEER ST
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City | BATON ROUGE
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State | LA
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Zip | 70807-3009
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Country | US
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Telephone | 225-775-9997
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Fax | 225-775-9810
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Provider Business Mailing Address
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Address Line | 30 HARBOR COVE DR
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City | THE WOODLANDS
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State | TX
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Zip | 77381-3339
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Country | US
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Telephone | 832-647-8897
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Fax | 281-362-9049
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CLARENCE R BAKER SR.
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Credential |
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Telephone | 832-647-8897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | SIL 11426
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License Number State | LA
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