NPIMap

Organization Active NPI

Sacred Holistic Path Sanctuary Refuge Incorporated

  • Community/Behavioral Health Agency
  • Tyler, TX
National Provider Identifier
1235792599
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SACRED HOLISTIC PATH SANCTUARY REFUGE INCORPORATED
Practice address
15360 FM 850
Tyler, TX 75707-3916
Phone
(936) 645-9939
Fax
(903) 253-0466
NPI assigned
Apr 22, 2019
Last updated
Jul 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Authorized official

Name
Hobert Stanley Miller, LMSWNPI 1073077673
Title
President
Phone
(903) 732-6271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Voluntary or Charitable Agency 251V00000X

Addresses

Primary practice location

15360 FM 850
Tyler, TX 75707-3916

Mailing address

P.O. Box 9636
Tyler, TX 75711
Phone (936) 645-9939

Other identifiers 1

IdentifierTypeStateIssuer
17799986OtherTXPRIVATE INSURANCE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1235792599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 9636",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75711",
            "telephone_number": "936-645-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15360 FM 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757073916",
            "telephone_number": "936-645-9939",
            "fax_number": "903-253-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HOLISTIC PATH SANCTUARY REFUGE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "HOBERT",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-732-6271",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "17799986",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.