Organization Active NPI

St. Genevieve Detox and Maintenance Inc.

  • Methadone Clinic
  • Clute, TX
National Provider Identifier
1114734977
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
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

Updated by the provider on May 12, 2026

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.