Provider Demographics
NPI:1235592296
Name:LAMB BEHAVIORAL HEALTH CENTER LLC
Entity Type:Organization
Organization Name:LAMB BEHAVIORAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:979-436-1956
Mailing Address - Street 1:1737 BRIARCREST DR STE 24
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2769
Mailing Address - Country:US
Mailing Address - Phone:979-436-1956
Mailing Address - Fax:979-846-8070
Practice Address - Street 1:1737 BRIARCREST DR STE 24
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2769
Practice Address - Country:US
Practice Address - Phone:979-436-1956
Practice Address - Fax:979-846-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty