NPIMap

Organization Active NPI

Mhmra of Brazos Valley

  • Adult Care Home Facility
  • Bryan, TX
National Provider Identifier
1457551509
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
MHMRA OF BRAZOS VALLEY
Practice address
1504 S Texas Ave
Bryan, TX 77802-1015
Phone
(979) 822-6467
Fax
(979) 821-9448
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Bill Kelly
Title
Executive Director
Phone
(979) 822-6467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

1504 S Texas Ave
Bryan, TX 77802-1015

Mailing address

1504 S Texas Ave
P.O. Box 4588
Bryan, TX 77802-1015
Phone (979) 822-6467

Other names 1

  • MHMRABV HCS/TX HM LVG Other name

National Provider Directory

National Provider Directory
Tax ID family
MHMR Authority of Brazos Valley5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1504 S Texas Ave
Bryan, TX 77802

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1457551509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 S TEXAS AVE",
            "address_2": "P.O. BOX 4588",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778021015",
            "telephone_number": "979-822-6467",
            "fax_number": "979-821-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778021015",
            "telephone_number": "979-822-6467",
            "fax_number": "979-821-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHMRA OF BRAZOS VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-822-6467"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MHMRABV HCS/TX HM LVG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.