Provider Demographics
NPI:1033784178
Name:NUECES COUNTY MHMR COMMUNITY CENTER
Entity Type:Organization
Organization Name:NUECES COUNTY MHMR COMMUNITY CENTER
Other - Org Name:NUECES CENTER FOR MENTAL HEALTH AND INTELLECTUAL DISABILITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-886-1037
Mailing Address - Street 1:1630 S BROWNLEE BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3134
Mailing Address - Country:US
Mailing Address - Phone:361-886-6900
Mailing Address - Fax:361-886-1379
Practice Address - Street 1:1630 S BROWNLEE BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3134
Practice Address - Country:US
Practice Address - Phone:361-886-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health