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NPI Code Detail

MEDICARE: SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P.

MEDICARE: SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1043543762
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P.
Provider Business Mailing Address
First Line : 1975 BABCOCK RD
Second Line : SUITE 140
City : SAN ANTONIO
State : TX
Zip : 78229-4584
Country : US
Telephone Number : 210-340-0898
Fax Number : 210-340-0901
Provider Business Practice Location Address
First Line : 1975 BABCOCK RD
Second Line : SUITE 140
City : SAN ANTONIO
State : TX
Zip : 78229-4584
Country : US
Telephone Number : 210-340-0898
Fax Number : 210-340-0901
Authorized Official
Title or Position : MANAGING MEMBER OF GENERAL PARTNER
Name : MR. NATHAN INGRAM
Credential :
Telephone Number : 281-914-1012
Provider Enumeration Date : 09/14/2009
Last Update Date : 09/19/2012

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Directions to “SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P. ” Practice Location

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