NPIMap

Organization Active NPI

Adapt Foundation Inc

  • Substance Abuse Rehabilitation Facility
  • Freeport, TX
National Provider Identifier
1497985998
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
3994-3995 Issued in TX
Legal business name
ADAPT FOUNDATION INC
Practice address
1103 N Avenue H
Freeport, TX 77541-4006
Phone
(979) 233-3826
Fax
(979) 233-3708
NPI assigned
Jul 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Authorized official

Name
Joseph Gardzina, LCDC
Title
Clinical Director
Phone
(832) 892-2055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 3994-3995 TX Primary

Addresses

Primary practice location

1103 N Avenue H
Freeport, TX 77541-4006

Mailing address

PO Box 474
Angleton, TX 77516-0474
Phone (979) 233-3826

Other identifiers 1

IdentifierTypeStateIssuer
065443601MedicaidTX

Other names 1

  • Brazos Place Other name

National Provider Directory

National Provider Directory
Tax ID family
Adapt Foundation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1103 N Avenue H
Freeport, TX 77541
Phone (855) 862-3278

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1497985998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775160474",
            "telephone_number": "979-233-3826",
            "fax_number": "281-377-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 N AVENUE H",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775414006",
            "telephone_number": "979-233-3826",
            "fax_number": "979-233-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAPT FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "GARDZINA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "832-892-2055",
        "authorized_official_credential": "LCDC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TX",
            "license": "3994-3995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065443601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brazos Place",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Freeport, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.