Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

BANYAN TEXAS, LLC
NPI 1629689559
Substance Abuse Rehabilitation Facility in Waelder, TX

Active since August 13, 2020CLIA 45D2204905 · Waiver
4168 COUNTY ROAD 444, WAELDER, TX 78959(830) 283-3003(830) 522-2003 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 15, 2026, May 13, 2025, Aug 2, 2024 and 3 more (6 updates tracked since 2020).

About Banyan Texas, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANYAN TEXAS, LLC (NPI 1629689559) is a healthcare organization registered as a substance abuse rehabilitation facility in Waelder, Texas and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through December 10, 2026 and lists Anastasia Nichole Nauman, Contracting And Cred Manager, as its authorized official.

NPPES Registry Identity

NPI1629689559
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBANYAN TEXAS, LLC
Location Address4168 COUNTY ROAD 444Waelder, TX 78959-5328
Mailing Address225 N Federal HwyPompano Beach, FL 33062-4319 · Fax (954) 781-7173
Fax(830) 522-2003
Organization SubpartNo
Authorized OfficialAnastasia Nichole NaumanContracting And Cred Manager · (410) 800-8861
Enumeration DateAugust 13, 2020
Last NPPES UpdateJuly 15, 20266 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
NPI 1629689559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

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.

Also ListedPsychiatric HospitalTaxonomy 283Q00000X
4168 COUNTY ROAD 444, Waelder, TX 78959

Other Identifiers 1

Medicaid4238503TX

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2204905

Banyan Texas LLC · Waelder, TX
Active · expires Dec 10, 2026
CLIA Number45D2204905
Laboratory TypeSubstance Abuse Treatment
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorDr. Shelly F. Haferkamp
Laboratory Phone(830) 283-3003
Laboratory LocationBanyan Texas LLC4168 County Road 444, Waelder, TX 78959
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
4168 COUNTY ROAD 444
WAELDER, TX 78959
Counselor (Addiction (Substance Use Disorder))
4168 COUNTY ROAD 444
WAELDER, TX 78959
Psychiatry & Neurology (Psychiatry)
4168 COUNTY ROAD 444
WAELDER, TX 78959

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banyan Texas, LLC's NPI number?

The NPI number for Banyan Texas, LLC is 1629689559. It was assigned to this organization in the NPPES registry on August 13, 2020.

Where is Banyan Texas, LLC located?

Banyan Texas, LLC is located at 4168 County Road 444, Waelder, TX 78959. The listed phone number is (830) 283-3003.

What is Banyan Texas, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Banyan Texas, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2204905) is associated with this NPI, valid through December 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Banyan Texas, LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Banyan Texas, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Banyan Texas, LLC was last updated on July 15, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.