NPIMap

Organization Active NPI

Canyon Lakes RTC

  • Professional Counselor
  • Lubbock, TX
National Provider Identifier
1932333846
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
64653 Issued in TX
Legal business name
CANYON LAKES RTC
Practice address
2402 Canyon Lake Dr
Lubbock, TX 79415-2000
Phone
(806) 762-5782
NPI assigned
May 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mrs. Lenise Staha
Title
Executive Director
Phone
(806) 762-5782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 64653 TX Primary

Addresses

Primary practice location

2402 Canyon Lake Dr
Lubbock, TX 79415-2000

Mailing address

2402 Canyon Lake Dr
Lubbock, TX 79415-2000
Phone (806) 762-5782

National Provider Directory

National Provider Directory
Tax ID family
Canyon Lakes Residential Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1932333846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 CANYON LAKE DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794152000",
            "telephone_number": "806-762-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 CANYON LAKE DR",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794152000",
            "telephone_number": "806-762-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON LAKES RTC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "STAHA",
        "authorized_official_first_name": "LENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "806-762-5782",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "64653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.