NPIMap

Organization Active NPI

Tri-County Behavioral Healthcare

  • Intellectual Disabilities Intermediate Care Facility
  • Conroe, TX
National Provider Identifier
1891711164
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
TRI-COUNTY BEHAVIORAL HEALTHCARE
Practice address
104 Patricia LN
Conroe, TX 77301-5138
Phone
(936) 521-6100
NPI assigned
Jul 13, 2006
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Beverly A Standley
Title
Reimbursement Manager
Phone
(936) 521-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

104 Patricia LN
Conroe, TX 77301-5138

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
000390501MedicaidTX

Other names 1

  • Patricia Street House Other name

National Provider Directory

National Provider Directory
Tax ID family
Tri County MHMR16 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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1891711164",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PATRICIA LN",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773015138",
            "telephone_number": "936-521-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY BEHAVIORAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "STANDLEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "936-521-6100"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000390501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patricia Street House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 27, 2015; 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.