ETHOS WELLNESS-THE PRAIRIE RECOVERY CENTER (NPI# 1598306862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598306862 |
| Entity Type | Organization |
| Organization Name | ETHOS WELLNESS-THE PRAIRIE RECOVERY CENTER |
| Practice Address |
5808 Wagner Rd Round Top TX 78954-5075 |
| Practice Telephone | 9798364975 |
| Mailing Telephone | 9798364975 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |
| Authorized Official Name | LORI PUCKETT (HR/ADMISSIONS) |
| Authorized Official Telephone | 9798364975 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
5808 WAGNER RD |
| City | ROUND TOP |
| State | TX |
| Zip Code | 78954-5075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043429236 | Vernon Monroe Brau | Dentist | 711 Round Top Road, Round Top, TX 78954-0108 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134469489 | Barbara Hough | Registered Nurse | 23 Glenwood Townhouse Rd, A, Round Top, NY 12473-5515 | 2013-02-25 |
| 1043429236 | Vernon Monroe Brau | Dentist | 711 Round Top Road, Round Top, TX 78954-0108 | 2007-05-22 |
| 1881720357 | Mary Louise Rossano | Social Worker | 52 Walnut Dr, Round Top, NY 12473 | 2007-02-26 |
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.