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General NPI Number Information
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NPI Number | 1962615997
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Entity Type | Organization
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Legal Business Name | JML WOODLANDS BEHAVIORAL CENTER INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 3516 EAST EXPRESSWAY 83 SUITE 112
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 956-968-8100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | MISSION
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State | TX
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Zip | 78573
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Country | US
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Telephone | 956-968-8100
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUAN M LOPEZ
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Credential | MSGC
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Telephone | 956-968-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 62639
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License Number State | TX
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