Provider Demographics
NPI:1649712951
Name:WESTBRIDGE RECOVERY CENTER, INC
Entity type:Organization
Organization Name:WESTBRIDGE RECOVERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:S.
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, LCDC, AADC
Authorized Official - Phone:281-608-7600
Mailing Address - Street 1:4107 ACORN LANE
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365
Mailing Address - Country:US
Mailing Address - Phone:281-608-7600
Mailing Address - Fax:281-608-7602
Practice Address - Street 1:4107 ACORN LANE
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365
Practice Address - Country:US
Practice Address - Phone:281-608-7600
Practice Address - Fax:281-608-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
324500000X, 101YM0800X, 324500000X
TX4245-4246324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty