Provider Demographics
NPI:1326139171
Name:THE SOUTH TEXAS CARPENTER'S HOUSE
Entity Type:Organization
Organization Name:THE SOUTH TEXAS CARPENTER'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:OUTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCDC
Authorized Official - Phone:361-358-1470
Mailing Address - Street 1:2507 LEXINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-7013
Mailing Address - Country:US
Mailing Address - Phone:361-358-1470
Mailing Address - Fax:361-354-5533
Practice Address - Street 1:2507 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-7013
Practice Address - Country:US
Practice Address - Phone:361-358-1470
Practice Address - Fax:361-354-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty