| Therapeutic Family Life | |
|
3809 S 2nd St Ste C400 Austin TX 78704-7059 | |
| (512) 451-7310 | |
| (512) 451-0394 |
| Full Name | Therapeutic Family Life |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3809 S 2nd St Ste C400, Austin, Texas |
| Authorized Official Name and Position | Leon Smith (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5124517310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Family Life 3809 S 2nd St Ste C400 Austin TX 78704-7059 Ph: (512) 451-7310 | Therapeutic Family Life 3809 S 2nd St Ste C400 Austin TX 78704-7059 Ph: (512) 451-7310 |
| NPI Number | 1679791677 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/21/2023 |
| Certification Date | 08/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679791677 | NPI | - | NPPES |
| 153602101 | Medicaid | TX | |
| 109348601 | Medicaid | TX | |
| 109348602 | Medicaid | TX | |
| 080030201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
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