NPIMap

Organization Active NPI

Central Texas Mental Health and Mental Retardation Center

Doing business as Center for Life Resources

  • Case Management Agency
  • Brownwood, TX
National Provider Identifier
1619196169
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CENTRAL TEXAS MENTAL HEALTH AND MENTAL RETARDATION CENTER
Doing business as
Center for Life Resources
Practice address
408 Mulberry St
Brownwood, TX 76801-1639
Phone
(325) 646-9574
NPI assigned
Apr 24, 2007
Last updated
Feb 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Authorized official

Name
Mr. Dion White
Title
Ceo
Phone
(325) 646-9574

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary
Developmental Disabilities Clinic/Center 261QD1600X NU
Counselor 101Y00000X 13184 TX
Counselor 101Y00000X 64151 TX
Counselor 101Y00000X 66441 TX
Professional Counselor 101YP2500X 09663 TX
Professional Counselor 101YP2500X 13474 TX
Clinical Social Worker 1041C0700X 16780 TX
Psychiatry Physician 2084P0800X C9164 TX
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

408 Mulberry St
Brownwood, TX 76801-1639

Mailing address

PO Box 250
Brownwood, TX 76804-0250
Phone (325) 646-9574

Other identifiers 7

IdentifierTypeStateIssuer
000732501MedicaidTX
1333395-01MedicaidTX
000373401MedicaidTX
1333395-04MedicaidTX
1333395-02MedicaidTX
000384001MedicaidTX
133339507MedicaidTX

Other names 1

  • Center for Life Resources Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001487 TX Part B Supplier - Clinic/Group Practice 5193613446 Receives reassigned benefits from 16 practitioners
Practice locations: Brownwood, TX

National Provider Directory

National Provider Directory
Tax ID family
Central TX MHMR Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

408 Mulberry St
Brownwood, TX 76801
Phone (325) 643-1721

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1619196169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768040250",
            "telephone_number": "325-646-9574",
            "fax_number": "325-643-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MULBERRY ST",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768011639",
            "telephone_number": "325-646-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS MENTAL HEALTH AND MENTAL RETARDATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DION",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-646-9574",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "13184",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "64151",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "66441",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "09663",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13474",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "16780",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "C9164",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000732501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333395-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000373401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333395-04",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1333395-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000384001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133339507",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Life Resources",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brownwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.