Healthcare Provider Details

I. General information

NPI: 1891325114
Provider Name (Legal Business Name): BEXAR COUNTY COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2020
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9411 DEL MAR CIR
SAN ANTONIO TX
78251-3504
US

IV. Provider business mailing address

9411 DEL MAR CIR
SAN ANTONIO TX
78251-3504
US

V. Phone/Fax

Practice location:
  • Phone: 830-469-5190
  • Fax:
Mailing address:
  • Phone: 830-469-5190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. MONICA ATHENA LARIOS
Title or Position: PROGRAM MANAGER
Credential:
Phone: 830-469-5190