Provider Demographics
NPI:1043280951
Name:TEXAS LAUREL RIDGE HOSPITAL LP
Entity type:Organization
Organization Name:TEXAS LAUREL RIDGE HOSPITAL LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SRVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:17720 CORPORATE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3500
Mailing Address - Country:US
Mailing Address - Phone:210-491-9400
Mailing Address - Fax:210-491-3517
Practice Address - Street 1:17720 CORPORATE WOODS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-3500
Practice Address - Country:US
Practice Address - Phone:210-491-9400
Practice Address - Fax:210-491-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000723283Q00000X
TX827024323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK149461125Medicaid
MS06704836Medicaid
TXHH6534OtherBC PARTIAL PIN
OK2000114300AMedicaid
MO0413423Medicaid
LA1707414Medicaid
NV6388590Medicaid
TXHH3825OtherBC CD PIN
AZ783771Medicaid
TXHH0825OtherBC ACUTE PIN
PA119465OtherCBH PIN
NM51754339Medicaid
IA0012278Medicaid
TX21240902Medicaid
AKHS795PIMedicaid
PA001951370001Medicaid
TXHH6623OtherBC RTC PIN
IA0012278Medicaid
PA001951370001Medicaid