1770643181 NPI number — SERVING CHILDREN AND ADULTS IN NEED, INC.

Table of content: (NPI 1770643181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770643181 NPI number — SERVING CHILDREN AND ADULTS IN NEED, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SERVING CHILDREN AND ADULTS IN NEED, INC.
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:
S.C.A.N., INC.
Provider Other Organization Name Type Code:
3
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:
1770643181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1605 SALDANA AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAREDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78041-6220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-724-5111
Provider Business Mailing Address Fax Number:
956-725-8367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1605 SALDANA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78041-6220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-724-5111
Provider Business Practice Location Address Fax Number:
956-725-8367
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DABDOUB
Authorized Official First Name:
ISELA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
956-724-5111

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0405X , with the licence number: 788-3455 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X , with the licence number: 788-A , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X , with the licence number: 788-C , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 788-S , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 788-3269 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 788-3090 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 788-F , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 137068608 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 303844001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 408346101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217569701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217698401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 218376601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 137068604 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217793301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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