NPIMap

Organization Active NPI

Pecan Valley MHMR Region

Doing business as Pecan Valley Centers for Behavioral and Developmental Healthcare

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cleburne, TX
National Provider Identifier
1225309537
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
3492-3493 Issued in TX
Legal business name
PECAN VALLEY MHMR REGION
Doing business as
Pecan Valley Centers for Behavioral and Developmental Healthcare
Practice address
1601 N Anglin St
Cleburne, TX 76031-1835
Phone
(817) 648-7133
Fax
(817) 645-3032
NPI assigned
Jan 18, 2012
Last updated
Jan 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Authorized official

Name
Mr. Coke Beatty
Title
Executive Director
Phone
(817) 579-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 3492-3493 TX Primary

Addresses

Primary practice location

1601 N Anglin St
Cleburne, TX 76031-1835

Mailing address

PO Box 729
Granbury, TX 76048-0729
Phone (817) 579-4400

Other names 1

  • Pecan Valley Centers for Behavioral and Developmental Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pecan Valley MHMR Region23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1225309537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760480729",
            "telephone_number": "817-579-4400",
            "fax_number": "817-579-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N ANGLIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760311835",
            "telephone_number": "817-648-7133",
            "fax_number": "817-645-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN VALLEY MHMR REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "COKE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "817-579-4400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "3492-3493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecan Valley Centers for Behavioral and Developmental Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.