| NPI | 1114006921 |
|---|---|
| Other Name | BRENHAM STATE SUPPORTED LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | SCOTT SCHALCHLIN Associate Commissioner 512-438-3076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-02-05 |