| The Fullbrook Center | |
|
204 Jefferson Kerrville TX 78028 | |
| (830) 302-2922 | |
| (830) 326-6660 |
| Full Name | The Fullbrook Center |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 204 Jefferson, Kerrville, Texas |
| Authorized Official Name and Position | Jose A Miranda (DIRECTOR OF UR) |
| Authorized Official Contact | 2104858065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fullbrook Center 184 Fullbrook Ln Fredericksburg TX 78624-8313 Ph: (830) 302-2922 | The Fullbrook Center 204 Jefferson Kerrville TX 78028 Ph: (830) 302-2922 |
| NPI Number | 1003689936 |
|---|---|
| Provider Enumeration Date | 11/02/2023 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003689936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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