| Organization Name: | BRAZOS INTENSIVE OUTPATIENT PROGRAM |
| NPI Number: | 1184978108 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BEN PATTERSON (CEO) |
| Mailing Address: | 257 Fm 927 Cr Morgan |
| State: | TX US |
| Postal Code: | 76671 |
| Phone Number: | 2542321550 |
| Fax Number: | 2547754040 |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 01/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 3593-3594 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |