GULF BEND MHMR CENTER (NPI# 1720057904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720057904 |
| Entity Type | Organization |
| Organization Name | GULF BEND MHMR CENTER |
| Practice Address |
6502 Nursery Dr Suite100 Victoria TX 77904-1178 |
| Practice Telephone | 3615750611 |
| Practice Fax Number | 3615750626 |
| Mailing Telephone | 3615750611 |
| Mailing Fax Number | 3615750626 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2010-08-03 |
| Authorized Official Name | MR. DONALD L POLZIN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3615750611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 251B00000X | Case Management | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 135254402 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326017518 | Gulf Bend Mhmr Center | Psychiatry & Neurology | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2006-03-17 |
| 1912976101 | Gulf Bend Mhmr Center | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2006-03-17 |
| 1346219516 | Gulf Bend Mhmr Center | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2006-03-17 |
| Street Address |
6502 NURSERY DR SUITE100 |
| City | VICTORIA |
| State | TX |
| Zip Code | 77904-1178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467434399 | Gulf Bend Mental Health Mental Retardation Center | Clinic/Center | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2005-11-16 |
| 1144774860 | Karen Kennemer | Community/Behavioral Health | 6502 Nursery Dr, Victoria, TX 77904-1178 | 2016-08-10 |
| 1457790057 | Sherryl K Sanders | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2013-06-18 |
| 1932445855 | Marilyn Joyce Swannack | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2012-12-20 |
| 1043591464 | Tracy Dawn Chase | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2011-08-30 |
| 1770888596 | Daniel Rodriguez | Counselor | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2011-01-26 |
| 1467648865 | Craig G. Chang, M.d., P.a. | Surgery | 6502 Nursery Dr, Suite 300, Victoria, TX 77904-1178 | 2007-09-19 |
| 1356482996 | Rogers Pharmacy #4 | Pharmacy | 6502 Nursery Dr, Suite 102, Victoria, TX 77904-1178 | 2007-02-08 |
| 1285668541 | Gulf Bend Mrmr Center Hcs Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2006-07-10 |
| 1306802814 | Craig Ge-sheng Chang | Surgery | 6502 Nursery Dr, Suite 300, Victoria, TX 77904-1178 | 2006-04-24 |
| Find all providers in the same location | ||||
| 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 | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
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|---|---|---|---|---|
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| 1548663495 | Mid-coast Family Services, Inc. | Case Management | 120 S Main St Ste 310, Victoria, TX 77901-8144 | 2014-10-07 |
| 1629101647 | Dept of Assistive & Rehab Serv - Victoria Field Office | Case Management | 1502 E Airline Rd Ste 13, Victoria, TX 77901-4116 | 2007-03-13 |
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| 1760081228 | Lighthouse Group Homes, LLC | Case Management | 2109 Quail Run Apt B, Mckinney, TX 75071-1013 | 2020-10-25 |
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| 1114524584 | Kimberly Marie Pittard | Case Management | 3906 Figure Four Lake Ln, Richmond, TX 77406-8084 | 2020-10-07 |
| 1821605312 | Mmk Group of Texas | Case Management | 21510 Hales Hunt Ct, Spring, TX 77388-6952 | 2020-09-28 |
| 1104433853 | Amy Sanford | Case Management | 23770 Springwoods Village Pkwy Apt 258, Spring, TX 77373-5104 | 2020-09-28 |
| 1316554215 | A New Way of Life Mentoring Services | Case Management | 7601 Fm 1960 Rd E, Humble, TX 77346-2209 | 2020-09-25 |
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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.