Provider Demographics
NPI:1891190906
Name:FOUR RIVERS OUTREACH INC
Entity Type:Organization
Organization Name:FOUR RIVERS OUTREACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-870-4000
Mailing Address - Street 1:210 S RUSK ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-7227
Mailing Address - Country:US
Mailing Address - Phone:903-870-4000
Mailing Address - Fax:903-870-4003
Practice Address - Street 1:402 WEST LAMAR
Practice Address - Street 2:1000
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-7227
Practice Address - Country:US
Practice Address - Phone:903-870-4000
Practice Address - Fax:903-870-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8175101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty