Provider Demographics
NPI:1841011996
Name:GULF BEND MENTAL HEALTH MENTAL RETARDATION CENTER
Entity type:Organization
Organization Name:GULF BEND MENTAL HEALTH MENTAL RETARDATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NEISSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-575-0611
Mailing Address - Street 1:6502 NURSERY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1181
Mailing Address - Country:US
Mailing Address - Phone:361-582-2331
Mailing Address - Fax:361-579-6913
Practice Address - Street 1:6502 NURSERY DR STE 100
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1181
Practice Address - Country:US
Practice Address - Phone:361-582-2331
Practice Address - Fax:361-579-6913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty