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General NPI Number Information
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NPI Number | 1720481021
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Entity Type | Organization
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Legal Business Name | SOLUTIONS TX
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 1887 COUNTY ROAD 6479
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City | DAYTON
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State | TX
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Zip | 77535-8254
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Country | US
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Telephone | 936-257-8189
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Fax | 936-257-8189
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Provider Business Mailing Address
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Address Line | 1887 COUNTY ROAD 6479
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City | DAYTON
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State | TX
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Zip | 77535-8254
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Country | US
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Telephone | 936-257-8189
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Fax | 936-257-8189
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JUANITA STOUT
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Credential | LCDC
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Telephone | 396-257-8189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3769-3770
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License Number State | TX
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