Provider Demographics
NPI:1124577440
Name:OBRC OPERATIONS, LLC
Entity Type:Organization
Organization Name:OBRC OPERATIONS, LLC
Other - Org Name:DRIFTWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-842-6767
Mailing Address - Street 1:1905 ELDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:DRIFTWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78619-2102
Mailing Address - Country:US
Mailing Address - Phone:512-842-6767
Mailing Address - Fax:512-842-6766
Practice Address - Street 1:1905 ELDER HILL RD
Practice Address - Street 2:
Practice Address - City:DRIFTWOOD
Practice Address - State:TX
Practice Address - Zip Code:78619-2102
Practice Address - Country:US
Practice Address - Phone:512-842-6767
Practice Address - Fax:512-842-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility