McEt-Waskom Limited Liability Company
Organization Active NPI Methadone Clinic · Waskom, TX
NPI 1184036790 · NPPES record last updated Jun 18, 2022
Key facts
- NPI
- 1184036790
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Methadone Clinic 261QM2800X
- License
- 1000008 (TX)
- Legal business name
- MCET-WASKOM LIMITED LIABILITY COMPANY
- Practice address
- 670 Spur 156
Waskom, TX 75692-9129 - Phone
- (903) 687-2093
- Fax
- (903) 687-2586
- NPI assigned
- Jun 2, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Rupert McCormac
- Title
- President
- Phone
- (800) 805-6989
Practitioners 6
-
Randal Ratzlaff, LCDC
-
Rupert James McCormac IV, M.D.
-
April Dawn Nelson, QMHP-R
National Provider Directory
Locations
670 Spur 156
Waskom, TX 75692
Phone (903) 687-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Methadone Clinic | 261QM2800X | 1000008 | TX | Yes |
| Primary Care Clinic/Center | 261QP2300X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
670 Spur 156
Waskom, TX 75692-9129
Mailing address
200 E Broad St Ste 300
Greenville, SC 29601-2891
Phone (800) 805-6989
Other names
- Crossroads Treatment Centers Waskom
Other providers in Waskom, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.