Organization · NPI-2

Bluebonnet Trails Community Mhmr Center

Clinic/Center, Mental Health (Including Community Mental Health Center) · Round Rock, TX

NPI number1124426226
StatusActive
Last updated in NPPESAug 28, 2023

Details

NPI
1124426226
Entity type
Organization (NPI-2)
Legal business name
Bluebonnet Trails Community Mhmr Center
Organization subpart
No
Enumeration date
Dec 5, 2014
Certification date
Aug 28, 2023
Last updated
Aug 28, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Other names

  • Bluebonnet Trails Community Services (Doing Business As)

Practice location

1009 N Georgetown St
Round Rock, TX 78664-3289

Phone 512-255-1720 · Fax 512-727-0130

Mailing address

1009 N Georgetown St
Round Rock, TX 78664-3289

Phone 512-255-1720 · Fax 512-727-0130

Authorized official

Peter Gallimore
Credentialing Coordinator
5122448374

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