MEDICARE: PRESBYTERIAN CHILDREN'S HOMES AND SERVICES

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
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	000043689	MO
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790879617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESBYTERIAN CHILDREN'S HOMES AND SERVICES

Provider Business Mailing Address
First Line	:	5920 W WILLIAM CANNON DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1902
Country	:	US
Telephone Number	:	573-756-6744
Fax Number	:	573-218-0445

Provider Business Practice Location Address
First Line	:	5920 W WILLIAM CANNON DR STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-1902
Country	:	US
Telephone Number	:	573-756-6744
Fax Number	:

Authorized Official
Title or Position	:	VP - PROGRAMS
Name	:	MR. ROBERT GERARD GIEGLING
Credential	:	M.A.
Telephone Number	:	314-989-9727

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/24/2024

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Directions to “PRESBYTERIAN CHILDREN'S HOMES AND SERVICES ” Practice Location

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