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General NPI Number Information
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NPI Number | 1992179485
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Entity Type | Organization
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Legal Business Name | SAGE RECOVERY & WELLNESS CENTER
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 7004 BEE CAVES RD. STE 2-200
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City | AUSTIN
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State | TX
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Zip | 78746
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Country | US
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Telephone | 512-306-1394
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Fax |
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Provider Business Mailing Address
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Address Line | 7004 BEE CAVES RD. STE 2-200
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City | AUSTIN
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State | TX
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Zip | 78746
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Country | US
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Telephone | 512-306-1394
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TIFFANY D ANSCHUTZ
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Credential |
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Telephone | 512-306-1394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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