Provider Demographics
NPI:1174793145
Name:REGIONAL EMPLOYEE ASSISTANCE PROGRAM
Entity type:Organization
Organization Name:REGIONAL EMPLOYEE ASSISTANCE PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:THORN
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-892-9813
Mailing Address - Street 1:2403 N LAURENT ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4119
Mailing Address - Country:US
Mailing Address - Phone:903-872-0003
Mailing Address - Fax:903-872-0010
Practice Address - Street 1:400 HOSPITAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2416
Practice Address - Country:US
Practice Address - Phone:903-872-0003
Practice Address - Fax:903-872-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID