TRI-COUNTY BEHAVIORAL HEALTHCARE NPI 1508887241

NPI Information

  • NPI: 1508887241
  • Provider Name: TRI-COUNTY BEHAVIORAL HEALTHCARE
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Other Name: HOLLY STREET HOUSE
  • Address: 1420 HOLLY ST
    LIBERTY, TX
    ZIP 77575
  • Phone: (936) 521-6100

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NPI Details

TRI-COUNTY BEHAVIORAL HEALTHCARE is an intermediate care facility mentally retarded in Liberty, TX. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. TRI-COUNTY BEHAVIORAL HEALTHCARE NPI is 1508887241. The provider is registered as an organization entity type.
The provider Other Name Is Holly Street House.

The provider's business location address is:

1420 HOLLY ST
LIBERTY, TX
ZIP 77575-118
Phone: (936) 521-6100

The provider's authorized official is Evan Roberson .
The authorized official title is Executive Director and has the following contact phone number (936) 521-6100.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 6/27/2024.

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
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000756601MEDICAIDTEXAS

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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