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General NPI Number Information
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NPI Number | 1043280951
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Entity Type | Organization
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Legal Business Name | TEXAS LAUREL RIDGE HOSPITAL LP
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 17720 CORPORATE WOODS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78259-3500
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Country | US
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Telephone | 210-491-9400
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Fax | 210-491-3517
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Provider Business Mailing Address
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Address Line | 17720 CORPORATE WOODS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78259-3500
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Country | US
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Telephone | 210-491-9400
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Fax | 210-491-3517
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Authorized Official
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Title or Position | SRVP CFO
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 827024
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 000723
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License Number State | TX
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