NPIMap

Organization Active NPI

Pecan Valley MHMR Region

  • Case Management Agency
  • Granbury, TX
National Provider Identifier
1083733364
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PECAN VALLEY MHMR REGION
Practice address
2101 W Pearl St
Granbury, TX 76048-1894
Phone
(817) 579-4400
Fax
(866) 452-5424
NPI assigned
Mar 28, 2007
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Michelle L Leonard
Title
Billing Manager
Phone
(817) 579-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

2101 W Pearl St
Granbury, TX 76048-1894

Mailing address

2101 W Pearl St
Granbury, TX 76048-1894
Phone (817) 579-4400

Other identifiers 1

IdentifierTypeStateIssuer
130724101MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Pecan Valley MHMR Region23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1083733364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481894",
            "telephone_number": "817-579-4400",
            "fax_number": "866-452-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481894",
            "telephone_number": "817-579-4400",
            "fax_number": "866-452-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN VALLEY MHMR REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "817-579-4400"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130724101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.