=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801205810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BILLY T. CATTAN RECOVERY OUTREACH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2014
-----------------------------------------------------
Last Update Date | 06/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 802 E CRESTWOOD DR
-----------------------------------------------------
City | VICTORIA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77901-3309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-576-4673
-----------------------------------------------------
Fax | 361-576-6557
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 802 E CRESTWOOD DR
-----------------------------------------------------
City | VICTORIA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77901-3309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-576-4673
-----------------------------------------------------
Fax | 361-576-6557
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. DANIEL L BARRIENTOS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 361-576-4673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------