Provider Demographics
| NPI: | 1679300412 |
|---|---|
| Name: | R-UTH CHILDREN AND FAMILY SERVICES |
| Entity type: | Organization |
| Organization Name: | R-UTH CHILDREN AND FAMILY SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | FOUNDER/EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | LA' TOYA |
| Authorized Official - Middle Name: | ANN |
| Authorized Official - Last Name: | BROUGHTON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 903-213-5407 |
| Mailing Address - Street 1: | 2865 COUNTY ROAD 413 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TYLER |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75704-4211 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 903-752-7512 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2865 COUNTY ROAD 413 |
| Practice Address - Street 2: | |
| Practice Address - City: | TYLER |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75704-4211 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 903-752-7512 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-09-16 |
| Last Update Date: | 2024-09-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
| No | 251B00000X | Agencies | Case Management | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | |
| No | 253J00000X | Agencies | Foster Care Agency | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center | Research |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 347C00000X | Transportation Services | Private Vehicle |
