Provider Demographics
NPI:1447575501
Name:SPINDLETOP MHMR SERVICES
Entity Type:Organization
Organization Name:SPINDLETOP MHMR SERVICES
Other - Org Name:SPINDLETOP MHMR SERVICES/ATAR
Other - Org Type:Other Name
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-839-1009
Mailing Address - Street 1:PO BOX 3846
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77704-3846
Mailing Address - Country:US
Mailing Address - Phone:409-839-1000
Mailing Address - Fax:
Practice Address - Street 1:2750 S 8TH ST
Practice Address - Street 2:BUILDING C
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-7719
Practice Address - Country:US
Practice Address - Phone:409-839-1000
Practice Address - Fax:409-839-1066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142-142A261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder