Initiative Care Group HCS

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

INITIATIVE CARE GROUP HCS

Practice address

730 Adams St
Beaumont, TX 77705-4126

Phone

(346) 240-0108

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Roger Agbortoko

Title

Director of Services

Phone

(346) 240-0108

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1285098764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 ADAMS ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777054126",
            "telephone_number": "346-240-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 ADAMS ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777054126",
            "telephone_number": "346-240-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INITIATIVE CARE GROUP HCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "AGBORTOKO",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES",
        "authorized_official_telephone_number": "346-240-0108"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.