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General NPI Number Information
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NPI Number | 1376185298
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Entity Type | Organization
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Legal Business Name | ELDER CARE BEHAVIORAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 10410 DOHERTY SPG
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City | SAN ANTONIO
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State | TX
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Zip | 78255-1041
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Country | US
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Telephone | 210-395-4520
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Fax | 210-395-4521
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Provider Business Mailing Address
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Address Line | 10410 DOHERTY SPG
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City | SAN ANTONIO
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State | TX
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Zip | 78255-1041
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Country | US
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Telephone | 210-395-4520
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Fax | 210-395-4521
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Authorized Official
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Title or Position | MD/OWNER
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Name | STRAIGHT LINE ARLA
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Credential |
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Telephone | 210-395-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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