Provider Demographics
NPI:1447462197
Name:REGENCY COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:REGENCY COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIAN
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:210-403-9372
Mailing Address - Street 1:2391 NE LOOP 410 STE 403
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5675
Mailing Address - Country:US
Mailing Address - Phone:210-403-9372
Mailing Address - Fax:210-495-1538
Practice Address - Street 1:2391 NE LOOP 410 STE 403
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5675
Practice Address - Country:US
Practice Address - Phone:210-403-9372
Practice Address - Fax:210-495-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84V261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities