BTRL, LTD
Organization Active NPI Substance Abuse Rehabilitation Facility · Elgin, TX
NPI 1396090403 · NPPES record last updated Jul 16, 2012
Key facts
- NPI
- 1396090403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 2385-2385A (TX)
- Legal business name
- BTRL, LTD
- Practice address
- 122 Fisher St
Elgin, TX 78621-3510 - Phone
- (972) 962-7374
- NPI assigned
- Jul 16, 2012
- Organization subpart
- No
Authorized official
- Name
- Matthew Luchini
- Title
- Accounts Manager
- Phone
- (928) 533-4220
Practitioners 1
-
Alejandro D Kudisch, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2130042 | Burning Tree Lodge | Certificate of waiver | Apr 30, 2027 |
National Provider Directory
Locations
122 Fisher St
Elgin, TX 78621
Phone (972) 962-7374
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 2385-2385A | TX | Yes |
Addresses
Primary practice location
122 Fisher St
Elgin, TX 78621-3510
Mailing address
PO Box 757
Kaufman, TX 75142-0757
Other names
- Burning Tree Lodge
Other providers in Elgin, TX
- Patricia Anne Bennett
- William T Biel
- Jennifer Lynn Boettcher
- Debbie Arnold Boettner
- Maria Bontrager
- Kimberly Cadena
- Allica Cardona
- Kathrin Carter
- Jacqueline M Champlain
- Chih Andrew Chen
All providers in Elgin, TX · Substance Abuse Rehabilitation Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.