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NPI Code Detail

MEDICARE: SEXUAL TRAUMA & ASSAULT RESPONSE SERVICES, INC.

MEDICARE: SEXUAL TRAUMA & ASSAULT RESPONSE SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1568805745
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEXUAL TRAUMA & ASSAULT RESPONSE SERVICES, INC.
Provider Business Mailing Address
First Line : 710 N CAMPBELL ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-5202
Country : US
Telephone Number : 915-533-7700
Fax Number : 915-533-6727
Provider Business Practice Location Address
First Line : 710 N CAMPBELL ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-5202
Country : US
Telephone Number : 915-533-7700
Fax Number : 915-533-6727
Authorized Official
Title or Position : FINANCE DIRECTOR
Name : ROBERT SHAMY
Credential :
Telephone Number : 915-533-7700
Provider Enumeration Date : 04/08/2013
Last Update Date : 06/20/2018

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