Provider Demographics
NPI:1215070362
Name:BUCKNER CHILDREN & FAMILY SERVICES OF DEEP EAST TEXAS
Entity type:Organization
Organization Name:BUCKNER CHILDREN & FAMILY SERVICES OF DEEP EAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-637-3300
Mailing Address - Street 1:3402 DANIEL MCCALL DR STE 21
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-7191
Mailing Address - Country:US
Mailing Address - Phone:936-637-3300
Mailing Address - Fax:936-634-3384
Practice Address - Street 1:3402 DANIEL MCCALL DR STE 21
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-7191
Practice Address - Country:US
Practice Address - Phone:936-637-3300
Practice Address - Fax:936-634-3384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSW161811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty