Innovative Homes of Deep East Texas, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

INNOVATIVE HOMES OF DEEP EAST TEXAS, INC.

Practice address

513 S 1St St
Lufkin, TX 75901-3867

Phone

(936) 639-5273

Fax

(936) 639-5286

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Andro Gene Branch, LBSW, CART

Title

Program Director

Phone

(936) 639-5273

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932138773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150925",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759150925",
            "telephone_number": "936-639-5273",
            "fax_number": "936-639-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S 1ST ST",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759013867",
            "telephone_number": "936-639-5273",
            "fax_number": "936-639-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HOMES OF DEEP EAST TEXAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRANCH",
        "authorized_official_first_name": "ANDRO",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "936-639-5273",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LBSW, CART"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.