| Border Region Mhmr Youth Empowerment Services Waiver | |
|
1500 Pappas St Laredo TX 78041-1701 | |
| (956) 794-3000 | |
| (956) 794-3325 |
| Full Name | Border Region Mhmr Youth Empowerment Services Waiver |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1500 Pappas St, Laredo, Texas |
| Authorized Official Name and Position | Daniel G Castillon (EXECTIVE DIRECTOR) |
| Authorized Official Contact | 9567943000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Border Region Mhmr Youth Empowerment Services Waiver 1500 Pappas St Laredo TX 78041-1701 Ph: (956) 794-3000 | Border Region Mhmr Youth Empowerment Services Waiver 1500 Pappas St Laredo TX 78041-1701 Ph: (956) 794-3000 |
| NPI Number | 1215308242 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 10/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215308242 | NPI | - | NPPES |
| 121989103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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