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Developmental Disabilities Management Services of Beaumont, LLC

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Beaumont, TX

NPI 1376940262 · NPPES record last updated Mar 5, 2023

Key facts

NPI
1376940262
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
DEVELOPMENTAL DISABILITIES MANAGEMENT SERVICES OF BEAUMONT, LLC
Practice address
10980 Pine Haven St
Beaumont, TX 77713-8700
Phone
(409) 832-4112
NPI assigned
Nov 21, 2014
Organization subpart
No

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Corporate family (same tax ID) 17

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

National Provider Directory

Tax ID family
Developmental Disabilities Management Services of Beaumont LLC (18 organizations share this tax ID)

Locations

10980 Pine Haven St
Beaumont, TX 77713
Phone (409) 899-9522

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X TX Yes

Addresses

Primary practice location

10980 Pine Haven St
Beaumont, TX 77713-8700

Mailing address

313 Congress St FL 5
Boston, MA 02210-1218
Phone (800) 388-5150

Other identifiers

IdentifierTypeStateIssuer
APPLIED FORMedicaidTX

Other providers in Beaumont, TX

All providers in Beaumont, TX · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Texas

Sources for this page

Verify at the official NPI Registry.