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General NPI Number Information
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NPI Number | 1811266547
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Entity Type | Organization
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Legal Business Name | SABINE VALLEY REGIONAL MHMR DBA COMMUNITY HEALTHCORE
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 950 N 4TH ST
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City | LONGVIEW
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State | TX
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Zip | 75601-5436
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Country | US
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Telephone | 903-758-0596
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6800
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City | LONGVIEW
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State | TX
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Zip | 75608-6800
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Country | US
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Telephone | 903-758-2471
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. INMAN WHITE
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Credential |
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Telephone | 903-758-2471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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