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General NPI Number Information
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NPI Number | 1730658170
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Entity Type | Organization
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Legal Business Name | CCES LLC
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 3184 HWY 172
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City | GANADO
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State | TX
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Zip | 77962-8735
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Country | US
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Telephone | 361-541-2038
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Fax | 833-799-3545
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | GANADO
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State | TX
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Zip | 77962-0092
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Country | US
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Telephone | 361-541-2038
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Fax | 833-799-3545
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Authorized Official
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Title or Position | OWNER
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Name | JANICE M CHRISTOPHER
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Credential | LPC
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Telephone | 361-541-2038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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