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General NPI Number Information
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NPI Number | 1811064512
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Entity Type | Organization
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Legal Business Name | HHH COMMUNITY SERVICES OF NACOGDOCHES INC.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 422 E MAIN ST STE 213
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City | NACOGDOCHES
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State | TX
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Zip | 75961-5261
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Country | US
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Telephone | 936-560-2588
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Fax | 936-560-9005
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Provider Business Mailing Address
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Address Line | 422 E MAIN ST STE 213
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City | NACOGDOCHES
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State | TX
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Zip | 75961-5261
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Country | US
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Telephone | 936-560-2588
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Fax | 936-560-9005
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Authorized Official
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Title or Position | QMRP
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Name | MRS. LINDA HARRISON
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Credential | BA
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Telephone | 936-560-2588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 118954
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License Number State | TX
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