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General NPI Number Information
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NPI Number | 1801942057
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF THE SOUTH, INC.
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Dates
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Enumeration Date | 01/27/2007
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 25752 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77494-2086
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Country | US
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Telephone | 281-392-7505
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Fax | 281-392-7560
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Provider Business Mailing Address
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Address Line | 8305 CROSS PARK DR
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City | AUSTIN
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State | TX
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Zip | 78754-5154
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Country | US
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Telephone | 512-459-1000
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Fax | 512-452-6855
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | JASON DRAKE
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Credential |
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Telephone | 281-392-7505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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