Healthcare Provider Details

I. General information

NPI: 1104122738
Provider Name (Legal Business Name): ANOTHER CHANCE 4 CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2011
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14009 LAYNE LOOP
LEANDER TX
78641
US

IV. Provider business mailing address

14009 LAYNE LOOP
LEANDER TX
78641
US

V. Phone/Fax

Practice location:
  • Phone: 737-587-5193
  • Fax: 512-238-1961
Mailing address:
  • Phone: 737-587-5193
  • Fax: 512-238-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number33763377
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number10616
License Number StateTX

VIII. Authorized Official

Name: AUBURNE L GALLAGHER
Title or Position: OWNER
Credential: LCDC, PHD
Phone: 512-230-1242