Gordon Wayne Jones LCDC BS

NPI 1396962619 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1396962619
Gender Male
Enumeration Date 04/19/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1619 WASHINGTON AVE
WACO TX, 76701-1134, US
Phone (254) 753-3626
Fax (254) 753-0715
Business Location
1619 WASHINGTON AVE
WACO TX, 76701-1134, US
Phone (254) 753-3626
Fax (254) 753-0715
Toxanomy
Taxonomy Code 324500000X
License State
License Number
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According to our database, Gordon Wayne Jones LCDC BS NPI is 1396962619, taxonomy code is 324500000X Gordon Wayne Jones LCDC BS physically located at 1619 Washington Ave, Waco TX, 76701-1134. NPI Number Gordon Wayne Jones LCDC BS has the Individual type.

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1396962619 NPI number is provided on an as is basis without warranty of any kind. 1396962619 is maintained by the National Plan & Provider Enumeration System. The contents of Gordon Wayne Jones LCDC BS are for informational purposes only.