| Providence Service Corporation Of Texas | |
|
1524 S. Ih35 Suite 210 Austin TX 78704 | |
| (512) 343-8606 | |
| (512) 343-8620 |
| Full Name | Providence Service Corporation Of Texas |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1524 S. Ih35, Austin, Texas |
| Authorized Official Name and Position | Tina Wier (BILLING COORDINATOR) |
| Authorized Official Contact | 5123438606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Service Corporation Of Texas 1524 S. Ih35 Suite 210 Austin TX 78704 Ph: (512) 343-8606 | Providence Service Corporation Of Texas 1524 S. Ih35 Suite 210 Austin TX 78704 Ph: (512) 343-8606 |
| NPI Number | 1215007141 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215007141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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