| Canyon Lakes Rtc | |
|
2402 Canyon Lake Dr Lubbock TX 79415-2000 | |
| (806) 762-5782 | |
| Not Available |
| Full Name | Canyon Lakes Rtc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2402 Canyon Lake Dr, Lubbock, Texas |
| Authorized Official Name and Position | Lenise Staha (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8067625782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Lakes Rtc 2402 Canyon Lake Dr Lubbock TX 79415-2000 Ph: (806) 762-5782 | Canyon Lakes Rtc 2402 Canyon Lake Dr Lubbock TX 79415-2000 Ph: (806) 762-5782 |
| NPI Number | 1932333846 |
|---|---|
| Provider Enumeration Date | 05/06/2009 |
| Last Update Date | 05/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932333846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 64653 (Texas) | Primary |
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