Provider Demographics
NPI:1871918771
Name:BEXAR COUNTY BOARD OF TRUSTEE FOR MHMR SERVICES
Entity type:Organization
Organization Name:BEXAR COUNTY BOARD OF TRUSTEE FOR MHMR SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-261-1072
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1000
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:8155 LONE SHADOW TRL
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2436
Practice Address - Country:US
Practice Address - Phone:210-659-5857
Practice Address - Fax:210-659-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-28
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073758660OtherCCP
TX1598804734OtherCOMMUNITY BASED ALTERNATIVES
TX1629185566OtherHOME AND COMMUNITY BASED SERVICES
TX1487791653OtherINTERMEDIATE CARE FACILITY
TX1942340526OtherTEXAS HOME LIVING WAIVER
TX1538338181OtherDAY ACTIVITY HEALTH SERVICES