Provider Demographics
NPI:1386958734
Name:TRI-COUNTY RECOVERY CENTER A TEXAS NON-PROFIT CORPORATION
Entity type:Organization
Organization Name:TRI-COUNTY RECOVERY CENTER A TEXAS NON-PROFIT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-828-0800
Mailing Address - Street 1:2107 N MAYS ST
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2155
Mailing Address - Country:US
Mailing Address - Phone:512-828-0800
Mailing Address - Fax:512-828-0947
Practice Address - Street 1:2107 N MAYS ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2155
Practice Address - Country:US
Practice Address - Phone:512-828-0800
Practice Address - Fax:512-828-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3137-3138261QR0405X
TX3137-3140261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder