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General NPI Number Information
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NPI Number | 1164796330
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Entity Type | Organization
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Legal Business Name | HILL COUUNTRY THERAPY SERVICES
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 522 SANDERLING
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City | SAN ANTONIO
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State | TX
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Zip | 78245-1798
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Country | US
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Telephone | 210-887-7095
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 291
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City | HELOTES
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State | TX
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Zip | 78023-0291
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Country | US
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Telephone | 210-887-7095
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Fax |
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Authorized Official
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Title or Position | CLINCAL DIRECTOR
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Name | MISS JACLYN MOLINA
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Credential |
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Telephone | 210-887-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 101499
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License Number State | TX
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