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General NPI Number Information
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NPI Number | 1124651682
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Entity Type | Organization
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Legal Business Name | BEE CAVE RECOVERY
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 1114 LOST CREEK BLVD STE G40
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City | AUSTIN
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State | TX
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Zip | 78746-6375
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Country | US
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Telephone | 737-222-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 LOST CREEK BLVD STE G40
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City | AUSTIN
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State | TX
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Zip | 78746-6375
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Country | US
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Telephone | 737-222-5155
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES SHELDON ANDERSON
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Credential | LMSW
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Telephone | 408-916-7479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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