Active NPI
St. Genevieve Detox and Maintenance Inc.
- Methadone Clinic
- Clute, TX
National Provider Identifier
1114734977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- Legal business name
- ST. GENEVIEVE DETOX AND MAINTENANCE INC.
- Practice address
- 141 Brazosport Blvd N
Clute, TX 77531-3745 - Phone
- (979) 265-0705
- Fax
- (979) 265-1178
- NPI assigned
- Dec 16, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ikenna Obuekwe
- Title
- Administrator
- Phone
- (346) 422-4475
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | Primary | ||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
141 Brazosport Blvd N
Clute, TX 77531-3745
Mailing address
141 Brazosport Blvd N
Clute, TX 77531-3745
Phone (979) 265-0705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opioid treatment program
- Medicare-enrolled since May 16, 2026
National Provider Directory
National Provider DirectoryLocations
141 Brazosport Blvd N
Clute, TX 77531
Phone (979) 265-0705
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Houston, TX
- NPI 1417944943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778544000000",
"number": "1114734977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 BRAZOSPORT BLVD N",
"city": "CLUTE",
"state": "TX",
"postal_code": "775313745",
"telephone_number": "979-265-0705",
"fax_number": "979-265-1178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 BRAZOSPORT BLVD N",
"city": "CLUTE",
"state": "TX",
"postal_code": "775313745",
"telephone_number": "979-265-0705",
"fax_number": "979-265-1178"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. GENEVIEVE DETOX AND MAINTENANCE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-16",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A",
"authorized_official_last_name": "OBUEKWE",
"authorized_official_first_name": "IKENNA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "346-422-4475"
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clute, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.