Organization Name: | CAMINO REAL COMMUNITY MHMR CENTER |
NPI Number: | 1487751715 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACY LOREN WILSON (REIMBURSEMENT OFFICER) |
Mailing Address: | 19965 Fm 3175 North Lytle |
State: | TX US |
Postal Code: | 78052 |
Phone Number: | 2103570300 |
Fax Number: | 2103570458 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | NONE |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |