11817 LANDRUM INC NPI 1922519727

NPI Information

  • NPI: 1922519727
  • Provider Name: 11817 LANDRUM INC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • :
  • CLIA Number: 45D2156731
  • Address: 4351 CROW RD
    BEAUMONT, TX
    ZIP 77706
  • Phone: (409) 299-8555

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NPI Details

11817 LANDRUM INC is a substance abuse rehabilitation facility in Beaumont, TX. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. 11817 LANDRUM INC NPI is 1922519727. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

4351 CROW RD
BEAUMONT, TX
ZIP 77706-910
Phone: (409) 299-8555
Fax: (409) 271-3075

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 45D2156731 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/19/2017 and was last updated on 7/17/2025.

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
1261QM0850XClinic/CenterAdult Mental HealthNo
2324500000XSubstance Abuse Rehabilitation FacilityYes

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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