1154527315 NPI number — BEHAVIORAL HEALTH SOLUTIONS OF SOUTH TEXAS

Table of content: (NPI 1154527315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154527315 NPI number — BEHAVIORAL HEALTH SOLUTIONS OF SOUTH TEXAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL HEALTH SOLUTIONS OF SOUTH TEXAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RIO GRANDE VALLEY COUNCIL, INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154527315
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5510 N. CAGE BLVD.
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
PHARR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-787-7111
Provider Business Mailing Address Fax Number:
956-781-2233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5510 N CAGE BLVD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
PHARR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78577-1812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-787-7111
Provider Business Practice Location Address Fax Number:
956-781-2233
Provider Enumeration Date:
06/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
956-787-7111

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X , with the licence number:  891-J , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1154527315 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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