NPIMap

Organization Active NPI

Heart of Texas Region Mental Health Mental Retardation Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waco, TX
National Provider Identifier
1861860892
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Practice address
1105 Jefferson Ave
Waco, TX 76701-1212
Phone
(254) 752-7889
Fax
(254) 756-3133
NPI assigned
Sep 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Mr. Daniel Thompson
Title
Data Admin
Phone
(254) 752-3451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1105 Jefferson Ave
Waco, TX 76701-1212

Mailing address

1105 Jefferson Ave
Waco, TX 76701-1212
Phone (254) 752-7889

Other identifiers 1

IdentifierTypeStateIssuer
08485902MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Heart of Texas Region Mental Health Mental Retardation Center16 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

Locations

1105 Jefferson Ave
Waco, TX 76701
Phone (254) 297-7000

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1861860892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 JEFFERSON AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011212",
            "telephone_number": "254-752-7889",
            "fax_number": "254-756-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 JEFFERSON AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011212",
            "telephone_number": "254-752-7889",
            "fax_number": "254-756-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DATA ADMIN",
        "authorized_official_telephone_number": "254-752-3451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08485902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.