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General NPI Number Information
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NPI Number | 1851048169
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Entity Type | Organization
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Legal Business Name | THE ZILKER CENTER LLC
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 11905 MUSTANG CHASE
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City | AUSTIN
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State | TX
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Zip | 78727-6629
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Country | US
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Telephone | 512-660-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 6009 GROVER AVE
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City | AUSTIN
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State | TX
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Zip | 78757-3421
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Country | US
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Telephone | 512-803-4160
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CANDICE KRASOVEC
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Credential |
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Telephone | 512-803-4160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment 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 | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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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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