Provider Demographics
NPI:1174818686
Name:RGB CENTER FOR BEHAVIORAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:RGB CENTER FOR BEHAVIORAL MANAGEMENT, LLC
Other - Org Name:CENTER FOR BEHAVIORAL MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-400-4648
Mailing Address - Street 1:804 PECAN BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2458
Mailing Address - Country:US
Mailing Address - Phone:956-687-4841
Mailing Address - Fax:956-585-3834
Practice Address - Street 1:804 PECAN BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2458
Practice Address - Country:US
Practice Address - Phone:956-687-4841
Practice Address - Fax:956-585-3834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty