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General NPI Number Information
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NPI Number | 1568630044
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Entity Type | Organization
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Legal Business Name | CAN BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 401 W TEXAS AVE
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City | BAYTOWN
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State | TX
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Zip | 77520-4751
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Country | US
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Telephone | 281-427-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 401 W TEXAS AVE
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City | BAYTOWN
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State | TX
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Zip | 77520-4751
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Country | US
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Telephone | 281-427-4226
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN HAVENAR
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Credential |
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Telephone | 281-427-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2538-A
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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 | 2538
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License Number State | TX
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Taxonomy #3
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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 | 2538-2538A
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License Number State | TX
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