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General NPI Number Information
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NPI Number | 1841670916
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Entity Type | Organization
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Legal Business Name | CAN BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 105 W PEARCE ST
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City | BAYTOWN
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State | TX
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Zip | 77520-7772
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Country | US
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Telephone | 281-427-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 401 W TEXAS AVE
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City | BAYTOWN
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State | TX
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Zip | 77520-4751
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN HAVENAR
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Credential |
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Telephone | 281-427-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 2538-3806
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License Number State | TX
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