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Rayfield Wayne Jefferson Sr.

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Coldspring, TX

NPI 1114165495 · NPPES record last updated Jan 26, 2009

Key facts

NPI
1114165495
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
2330 FM 222
Coldspring, TX 77331
Phone
(936) 653-4113
NPI assigned
Jan 26, 2009
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

  • Rayfield Jefferson Intellectual and/or Developmental Disabilities Residential Treatment Facility · Coldspring, TX · NPI 1811135387
    NPD (past) RESIDENTIAL TREATMENT FACILITY, INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Rayfield Jefferson Residential Treatment Facility, Intellectual and/Or Developmental Disabilities Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

2330 FM 222
Coldspring, TX 77331

Mailing address

PO Box 142
Coldspring, TX 77331-0142
Phone (936) 653-4113

Other providers in Coldspring, TX

All providers in Coldspring, TX · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

Sources for this page

Verify at the official NPI Registry.