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202 N Main St San Angelo TX 76903-4842 | |
| (325) 658-7750 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 202 N Main St, San Angelo, Texas |
| Authorized Official Name and Position | Gregory Rowe (CEO) |
| Authorized Official Contact | 3256587750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1501 W Beauregard Ave San Angelo TX 76901-4004 Ph: (325) 658-7750 | 202 N Main St San Angelo TX 76903-4842 Ph: (325) 658-7750 |
| NPI Number | 1649987496 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649987496 | NPI | - | NPPES |
| 4660-4661 | Other | TX | SUBSTANCE ABUSE TREATMENT FACILITY LICENSE |
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