| Goodwill Industries Of East Texas, Inc. | |
|
409 W Locust St Tyler TX 75702-5644 | |
| (903) 593-8438 | |
| Not Available |
| Full Name | Goodwill Industries Of East Texas, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 409 W Locust St, Tyler, Texas |
| Authorized Official Name and Position | Kimberly Lewis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9035938438 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodwill Industries Of East Texas, Inc. 409 W Locust St Tyler TX 75702-5644 Ph: (903) 593-8438 | Goodwill Industries Of East Texas, Inc. 409 W Locust St Tyler TX 75702-5644 Ph: (903) 593-8438 |
| NPI Number | 1295148989 |
|---|---|
| Provider Enumeration Date | 06/10/2014 |
| Last Update Date | 06/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295148989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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