Provider Demographics
NPI:1467035733
Name:LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION
Entity type:Organization
Organization Name:LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-767-1648
Mailing Address - Street 1:904 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-3924
Mailing Address - Country:US
Mailing Address - Phone:806-766-0273
Mailing Address - Fax:
Practice Address - Street 1:3804 INTERSTATE 27
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2028
Practice Address - Country:US
Practice Address - Phone:806-766-0273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services