Provider Demographics
NPI: | 1497536320 |
---|---|
Name: | GARLAND TREATMENT CENTER INC |
Entity Type: | Organization |
Organization Name: | GARLAND TREATMENT CENTER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CORINA |
Authorized Official - Middle Name: | ALVAREZ |
Authorized Official - Last Name: | RIOJAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 972-203-1141 |
Mailing Address - Street 1: | 6246 BROADWAY BLVD STE 102 |
Mailing Address - Street 2: | |
Mailing Address - City: | GARLAND |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75043-5900 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-203-1141 |
Mailing Address - Fax: | 972-203-1215 |
Practice Address - Street 1: | 6246 BROADWAY BLVD STE 102 |
Practice Address - Street 2: | |
Practice Address - City: | GARLAND |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75043-5900 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-203-1141 |
Practice Address - Fax: | 972-203-1215 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-10-06 |
Last Update Date: | 2023-10-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |