Gulf Bend Mrmr Center Icf/mr
NPI #1932139979 in Port Lavaca, Texas
Provider Information
- NPI Number
- 1932139979
- Entity Type
- Organization
- Organization Name
- Gulf Bend Mrmr Center Icf/mr
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jul 4, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 102 BURNET ST
- City
- Port Lavaca
- State
- Texas
- ZIP Code
- 77979-2611
- Phone
- (361) 575-0611
Authorized Official
- Name
- DONALD L POLZIN
- Title
- EXECUTIVE DIRECTOR
- Phone
- (361) 575-0611
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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