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General NPI Number Information
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NPI Number | 1730399338
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Entity Type | Organization
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Legal Business Name | BAY AREA COUNCIL ON DRUGS AND ALCOHOL
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1300 A BAY AREA BLVD SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77058
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Country | US
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Telephone | 281-212-2900
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Fax | 281-212-2901
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Provider Business Mailing Address
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Address Line | 1300 A BAY AREA BLVD SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77058
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Country | US
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Telephone | 281-212-2900
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Fax | 281-212-2901
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Authorized Official
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Title or Position | SERVICE COORDINATOR
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Name | MS. MARIA DEL REFUGIO MARTINEZ
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Credential | L C D C
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Telephone | 281-212-2906
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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 | 8415
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License Number State | TX
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