NPIMap

Organization Active NPI

Tri-County Behavioral Healthcare

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Conroe, TX
National Provider Identifier
1629398367
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
3208-3209 Issued in TX
Legal business name
TRI-COUNTY BEHAVIORAL HEALTHCARE
Practice address
233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990
Phone
(936) 521-6100
Fax
(936) 760-2898
NPI assigned
Jun 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Evan Roberson
Title
Executive Director
Phone
(936) 521-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 3208-3209 TX Primary

Addresses

Primary practice location

233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990

Mailing address

PO Box 3067
Conroe, TX 77305-3067
Phone (936) 521-6100

Other identifiers 1

IdentifierTypeStateIssuer
081844502MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Tri-County Behavioral Healthcare16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1629398367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3067",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773053067",
            "telephone_number": "936-521-6100",
            "fax_number": "936-760-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SGT ED HOLCOMB BLVD S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041990",
            "telephone_number": "936-521-6100",
            "fax_number": "936-760-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY BEHAVIORAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "936-521-6100"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "3208-3209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081844502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.