11817 LANDRUM INC NPI 1457822538

NPI Information

NPI: 1457822538
Provider Name: 11817 LANDRUM INC
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Doing Business As: CONNECTED PATH RECOVERY
CLIA Number: 45D2145711
Address: 1505 CORNERSTONE CT
BEAUMONT, TX
ZIP 77706
Phone: (409) 299-8555

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NPI Details

11817 LANDRUM INC is a rehabilitation and substance use disorder clinic center in Beaumont, TX. 11817 LANDRUM INC NPI is 1457822538. The provider is registered as an organization entity type.
The provider Is Doing Business As Connected Path Recovery.

The provider's business location address is:

1505 CORNERSTONE CT
BEAUMONT, TX
ZIP 77706-899
Phone: (409) 299-8555

The provider's authorized official is Regina Michelle Tate .
The authorized official title is Ceo and has the following contact phone number (409) 853-2273.

The CLIA number assigned to this NPI record is 45D2145711 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2018 and was last updated on 6/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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