GULF BEND MRMR CENTER ICF/MR (NPI# 1649200684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649200684 |
| Entity Type | Organization |
| Organization Name | GULF BEND MRMR CENTER ICF/MR |
| Practice Address |
306 Edinburgh St Victoria TX 77904-2864 |
| Mailing Address |
1502 E Airline Rd Suite 25 Victoria TX 77901-4112 |
| Practice Telephone | 3615750611 |
| Practice Fax Number | 3615822329 |
| Mailing Telephone | 3615750611 |
| Mailing Fax Number | 3615822329 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DONALD POLZIN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3615750611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932139979 | Gulf Bend Mrmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Burnet St, Port Lavaca, TX 77979-2611 | 2006-07-04 |
| 1992735955 | Gulf Bend Mrmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 N Wheeler St, Victoria, TX 77901-4849 | 2006-07-04 |
| Street Address |
306 EDINBURGH ST |
| City | VICTORIA |
| State | TX |
| Zip Code | 77904-2864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124489364 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 Edinburgh St, Victoria, TX 77904-2864 | 2016-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600384 | Bertha P Mendieta | Physician Assistant | Citizens Victoria Surgical Associates, 2705 Hospital Drive Suite 400, Building B, Victoria, TX 77904 | 2019-10-14 |
| 1952968901 | Eliza Welder | Counselor | 6502 Nursery Dr. Suite, Suite 100, Victoria, TX 77904 | 2019-05-24 |
| 1154806529 | Tammy Lynn Hogan | Counselor | 4702 N. Laurent Ste D, Victoria, TX 77904 | 2018-10-01 |
| 1740724939 | Sarah Ritchea | Counselor | 6502 Nursery Dr. Suite 100, Victoria, TX 77904 | 2016-12-07 |
| 1992177489 | World of Words Speech & Feeding Services, LLC | Speech-Language Pathologist | 120 Appaloosa Dr., Victoria, TX 77904 | 2015-10-23 |
| 1396115739 | Katelin Mcvey | Physician Assistant | 106 Springwood Drive, Suite 100, Victoria, TX 77904 | 2015-09-28 |
| 1689070062 | Jeremy M Thompson Dds Ms Pllc | Clinic/Center | 103 Professional Park Driv, Victoria, TX 77904 | 2014-11-12 |
| 1265864144 | Pf Development 23, LLC | Hospice Care, Community Based | 1501 E Mockingbird Ln Ste 301b, Victoria, TX 77904 | 2013-08-02 |
| 1053669762 | Victoria Dentistry, Pllc | Dentist | 8809 North Navarro, Ste.100, Victoria, TX 77904 | 2012-08-28 |
| 1508126442 | Ayo Adu, M.d., Pllc | Family Medicine | 9410 Ne Zac Lentz Parkway, Suite 200, Victoria, TX 77904 | 2012-05-25 |
| Find all providers in zip 77904 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295295160 | Supportive Family Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2189 K V Rd, Victoria, VA 23974-2538 | 2019-03-25 |
| 1437189487 | Gulf Bend Mhmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Bellevue St, Victoria, TX 77904-1424 | 2006-07-04 |
| 1992735955 | Gulf Bend Mrmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 N Wheeler St, Victoria, TX 77901-4849 | 2006-07-04 |
| 1124489364 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 Edinburgh St, Victoria, TX 77904-2864 | 2016-03-16 |
| 1033579651 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 N Wheeler St, Victoria, TX 77901-4849 | 2016-02-24 |
| 1245690866 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Bellevue St, Victoria, TX 77904-1424 | 2016-02-24 |
| 1952336398 | Gulf Bend Mhmr Center Txhml Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1502 E Airline Rd, Suite 25, Victoria, TX 77901-4112 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581782 | Joyful Psalm | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1354 Ravenwood Ct, Crowley, TX 76036-3472 | 2020-09-04 |
| 1790394161 | Modern Vintage Residential Care, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4015 Alexis Tate Cir, Missouri City, TX 77459-5039 | 2020-07-30 |
| 1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
| 1568093888 | James Micah Howard | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11911 Lakewood Trl, Tomball, TX 77377-8563 | 2020-01-27 |
| 1518507110 | Gems Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5810 Liverpool St, Aubrey, TX 76227-1909 | 2020-01-10 |
| 1366081812 | Abundant Care Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Maxfield St, Waco, TX 76705-2967 | 2020-01-02 |
| 1306487426 | Fort Healthcare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5833 Oakbend Trail, #200, Fort Worth, TX 76132-3900 | 2019-09-30 |
| 1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
| 1871148171 | Kenneth Allen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 135 E Menefee St, Lufkin, TX 75901-4701 | 2019-08-05 |
| 1124673553 | 1st A & M Healthcare Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 504 Spicewood Dr, Desoto, TX 75115-1485 | 2019-08-02 |
| Find all providers with the same taxonomy | ||||
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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.