NPIMap

Organization Active NPI

Border Region MHMR Youth Empowerment Services Waiver

  • Community/Behavioral Health Agency
  • Laredo, TX
National Provider Identifier
1215308242
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BORDER REGION MHMR YOUTH EMPOWERMENT SERVICES WAIVER
Practice address
1500 Pappas St
Laredo, TX 78041-1701
Phone
(956) 794-3000
Fax
(956) 794-3325
NPI assigned
Oct 16, 2015
Last updated
Oct 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Mr. Daniel G Castillon
Title
Exective Director
Phone
(956) 794-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1500 Pappas St
Laredo, TX 78041-1701

Mailing address

1500 Pappas St
Laredo, TX 78041-1701
Phone (956) 794-3000

Other identifiers 1

IdentifierTypeStateIssuer
121989103MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Border Region MHMR Community Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1215308242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411701",
            "telephone_number": "956-794-3000",
            "fax_number": "956-794-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411701",
            "telephone_number": "956-794-3000",
            "fax_number": "956-794-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORDER REGION MHMR YOUTH EMPOWERMENT SERVICES WAIVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "CASTILLON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECTIVE DIRECTOR",
        "authorized_official_telephone_number": "956-794-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121989103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.