Provider Demographics
NPI:1922117910
Name:RECLAMATION COUNSELING CENTER, PC
Entity Type:Organization
Organization Name:RECLAMATION COUNSELING CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-576-3385
Mailing Address - Street 1:506 GLASCOW ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1406
Mailing Address - Country:US
Mailing Address - Phone:361-576-3385
Mailing Address - Fax:361-573-7425
Practice Address - Street 1:506 GLASCOW ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1406
Practice Address - Country:US
Practice Address - Phone:361-576-3385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080282901Medicaid
TX0098EFOtherBLUECROSS/BLUESHIELD