NPIMap

Organization Active NPI

Heart of Texas Region Mental Health Mental Retardation Center

  • Developmental Disabilities Clinic/Center
  • Waco, TX
National Provider Identifier
1881778025
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER
Practice address
3420 W Waco Dr
Waco, TX 76710-5437
Phone
(254) 757-3933
Fax
(254) 752-1931
NPI assigned
Oct 24, 2006
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
Executive Director
Phone
(254) 752-3451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X TX Primary

Addresses

Primary practice location

3420 W Waco Dr
Waco, TX 76710-5437

Mailing address

110 S 12TH St
P O Box
Waco, TX 76701-1810
Phone (254) 752-3451

Other identifiers 1

IdentifierTypeStateIssuer
111409201MedicaidTX

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

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1881778025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 12TH ST",
            "address_2": "P O BOX",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011810",
            "telephone_number": "254-752-3451",
            "fax_number": "254-752-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 W WACO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105437",
            "telephone_number": "254-757-3933",
            "fax_number": "254-752-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF TEXAS REGION MENTAL HEALTH MENTAL RETARDATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "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": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "254-752-3451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111409201",
            "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.