Provider Demographics
NPI:1851458087
Name:WILLOW BEND CENTER
Entity Type:Organization
Organization Name:WILLOW BEND CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT TO CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-236-4577
Mailing Address - Street 1:407 E MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5423
Mailing Address - Country:US
Mailing Address - Phone:903-236-4577
Mailing Address - Fax:903-236-0246
Practice Address - Street 1:407 E MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5423
Practice Address - Country:US
Practice Address - Phone:903-236-4577
Practice Address - Fax:903-236-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX849142322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children