NPIMap

Organization Active NPI

Heart of Texas Region Mental Health Mental Retardation Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waco, TX
National Provider Identifier
1043394281
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Practice address
110 S 12TH St
Waco, TX 76701-1810
Phone
(254) 752-3451
Fax
(254) 756-3133
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Mr. Daniel Thompson
Title
Executive Director
Phone
(254) 752-3451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X TX Primary

Addresses

Primary practice location

110 S 12TH St
Waco, TX 76701-1810

Mailing address

PO Box 890
Waco, TX 76703-0890
Phone (254) 752-3451

Other identifiers 1

IdentifierTypeStateIssuer
111409203MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Heart of Texas Region Mental Health Mental Retardation Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

110 S 12th St
Waco, TX 76701
Phone (254) 297-7124

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1043394281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767030890",
            "telephone_number": "254-752-3451",
            "fax_number": "254-756-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 12TH ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011810",
            "telephone_number": "254-752-3451",
            "fax_number": "254-756-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "254-752-3451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111409203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.