NPIMap

Organization Active NPI

Sabine Valley Regional MHMR Center

Doing business as Community Healthcore

  • Specialist
  • Longview, TX
National Provider Identifier
1821214537
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SABINE VALLEY REGIONAL MHMR CENTER
Doing business as
Community Healthcore
Early Childhood Intervention
Practice address
107 Woodbine PL Unit 775
Longview, TX 75601-2912
Phone
(903) 918-5806
Fax
(903) 295-5803
NPI assigned
Apr 18, 2007
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Rosemary O Villarreal
Title
Provider Enrollment/Credentialing
Phone
(903) 234-4226

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU
Specialist 174400000X NU Primary

Addresses

Primary practice location

107 Woodbine PL Unit 775
Longview, TX 75601-2912

Mailing address

107 Woodbine PL Unit 775
Longview, TX 75601-2912
Phone (903) 918-5806

Other identifiers 1

IdentifierTypeStateIssuer
137921605MedicaidTX

Other names 2

  • Community Healthcore Doing business as
  • Early Childhood Intervention Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sabine Valley Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

107 Woodbine Pl
Unit 775
Longview, TX 75601
Phone (903) 757-8194

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1821214537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL UNIT 775",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-918-5806",
            "fax_number": "903-295-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL UNIT 775",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-918-5806",
            "fax_number": "903-295-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SABINE VALLEY REGIONAL MHMR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT/CREDENTIALING",
        "authorized_official_telephone_number": "903-234-4226"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137921605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Healthcore",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Early Childhood Intervention",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Early Childhood Intervention",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.