Healthcare Provider Details

I. General information

NPI: 1912020645
Provider Name (Legal Business Name): HEALTHY FAMILIES SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2556 HUNT ST
NEW BRAUNFELS TX
78130-2998
US

IV. Provider business mailing address

2556 HUNT ST
NEW BRAUNFELS TX
78130-2998
US

V. Phone/Fax

Practice location:
  • Phone: 210-685-1529
  • Fax: 866-556-8569
Mailing address:
  • Phone: 210-685-1529
  • Fax: 866-556-8569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number39042
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number61423
License Number StateTX

VIII. Authorized Official

Name: MISS SHAWNE STACIE ORTIZ
Title or Position: OWNER
Credential: MA, LPC, NCC, LBSW
Phone: 830-822-7375