Provider Demographics
NPI:1073729810
Name:RECOVERY COUNCIL OF SOUTHEAST TEXAS
Entity Type:Organization
Organization Name:RECOVERY COUNCIL OF SOUTHEAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRIETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-842-2408
Mailing Address - Street 1:4675 WASHINGTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-4321
Mailing Address - Country:US
Mailing Address - Phone:409-842-2408
Mailing Address - Fax:409-842-2462
Practice Address - Street 1:4675 WASHINGTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-4321
Practice Address - Country:US
Practice Address - Phone:409-842-2408
Practice Address - Fax:409-842-2462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149-149H261QR0405X
TX149-149F261QR0405X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214802501Medicaid
TX205935402Medicaid
TX218017601Medicaid