| Organization Name: | EAST TEXAS SUPPORT SERVICES INC |
| NPI Number: | 1841568045 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERESA JANEAUX (EXECUTIVE DIRECTOR) |
| Mailing Address: | 109 W Water St Jasper |
| State: | TX US |
| Postal Code: | 759514423 |
| Phone Number: | 4093848751 |
| Fax Number: | 4094890289 |
| NPI Enumeration Date: | 12/02/2011 |
| NPI Last Update Date: | 12/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |