Coastal Plains Community MHMR Center
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Portland, TX
NPI 1487367173 · NPPES record last updated Feb 5, 2025
Key facts
- NPI
- 1487367173
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- COASTAL PLAINS COMMUNITY MHMR CENTER
- Practice address
- 200 Marriott Dr
Portland, TX 78374-2213 - Phone
- (361) 777-3991
- NPI assigned
- Dec 28, 2022
- Organization subpart
- No
Authorized official
- Name
- Leonel Trejo
- Title
- Chief Executive Officer
- Phone
- (361) 777-3991
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 10
Practitioners 3
-
Richard Gerard Sanchez, L.P.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040902000680 | TX | Part B Supplier - Clinic/Group Practice | 1557337490 |
Receives reassigned benefits from 19 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beeville, TX; Taft, TX; San Diego, TX; Rockport, TX; Portland, TX; Kingsville, TX; Falfurrias, TX; Aransas Pass, TX… |
National Provider Directory
- Tax ID family
- Coastal Plains Community Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
200 Marriott Dr
Portland, TX 78374-2213
Mailing address
200 Marriott Dr
Portland, TX 78374-2213
Phone (361) 777-3991
Other providers in Portland, TX
- Coastal Health Diagnostics Laboratory LLC
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
- Coastal Plains Community MHMR Center
All providers in Portland, TX · Substance Use Disorder Rehabilitation Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.