Healthcare Provider Details

I. General information

NPI: 1497663736
Provider Name (Legal Business Name): AUSTIN CENTER FOR TEENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 ELLIOTT RANCH RD
BUDA TX
78610-9334
US

IV. Provider business mailing address

815 ELLIOTT RANCH RD
BUDA TX
78610-9334
US

V. Phone/Fax

Practice location:
  • Phone: 949-620-6135
  • Fax:
Mailing address:
  • Phone: 737-345-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR CAVENDER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 737-345-8912