Provider Demographics
NPI:1750302923
Name:REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC
Entity Type:Organization
Organization Name:REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-3007
Mailing Address - Street 1:2403 N LAURENT ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4119
Mailing Address - Country:US
Mailing Address - Phone:361-579-0315
Mailing Address - Fax:361-579-0325
Practice Address - Street 1:5730 SHERWOOD WAY
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-5642
Practice Address - Country:US
Practice Address - Phone:325-944-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080138304Medicaid
TX080138304Medicaid
TXCK3300Medicare PIN
TXCH0707Medicare PIN