Provider Demographics
NPI:1417667106
Name:CEAETTAS FAMILY SERVICES , LLC
Entity Type:Organization
Organization Name:CEAETTAS FAMILY SERVICES , LLC
Other - Org Name:SWEET PEA ADOBE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CEAETTA
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:RENFRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-383-8399
Mailing Address - Street 1:PO BOX 793
Mailing Address - Street 2:
Mailing Address - City:BUNA
Mailing Address - State:TX
Mailing Address - Zip Code:77612-0793
Mailing Address - Country:US
Mailing Address - Phone:409-383-8399
Mailing Address - Fax:
Practice Address - Street 1:215 COUNTY ROAD 746
Practice Address - Street 2:
Practice Address - City:BUNA
Practice Address - State:TX
Practice Address - Zip Code:77612-6333
Practice Address - Country:US
Practice Address - Phone:409-383-8399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty