Huntsville Clinic, Inc.

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

TX-10235-M Issued in TX

Legal business name

HUNTSVILLE CLINIC, INC.

Doing business as

Conroe Treatment & Recovery Center

Practice address

501 Everett St
Conroe, TX 77301-1826

Phone

(936) 441-9172

Fax

(936) 441-9177

NPI assigned

Aug 9, 2010

Last updated

Oct 29, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

HUNTSVILLE CLINIC, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Stacey R Harris, LCDC

Title

Ceo

Phone

(936) 441-9172

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Conroe Treatment & Recovery Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Huntsville Clinic Inc2 organizations share this tax ID, including this one

Part of

Huntsville Clinic Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Huntsville Clinic, Inc

  • Methadone Clinic
  • Huntsville, TX
  • NPI 1265615462
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Huntsville Clinic, Inc

  • Methadone Clinic
  • Huntsville, TX
  • NPI 1265615462
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1003121526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 EVERETT ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011826",
            "telephone_number": "936-441-9172",
            "fax_number": "936-441-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EVERETT ST",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011826",
            "telephone_number": "936-441-9172",
            "fax_number": "936-441-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUNTSVILLE CLINIC, INC.",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "936-441-9172",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "TX",
            "license": "TX-10235-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT YET ISSUED",
            "identifier": "NOT ISSUED YET",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conroe Treatment & Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marcus Hughes, MT-BC
• Hannah Humphries
• Kassandra Raesine Hunter, RN
• Wendi Marie Hunter, MS, MJ, PHD
• Hunts Legacy Group LLC (Comfort Cares of East Texas)
• Lu-Cheree De Jager Hurt, LPC
• Yve Thaller Huttenbach, M.D.
• Brooks Hutton, APRN
• Connie C Hutton
• Kimberly Michelle Morris Ibarra

• Methadone Clinic in Conroe, TX
• Providers in Conroe, TX by specialty
• Methadone Clinic in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.