MEDICARE: BEXAR COUNTY COMMUNITY SERVICES LLC

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1891325114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEXAR COUNTY COMMUNITY SERVICES LLC

Provider Business Mailing Address
First Line	:	9411 DEL MAR CIR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3504
Country	:	US
Telephone Number	:	830-469-5190
Fax Number	:

Provider Business Practice Location Address
First Line	:	9411 DEL MAR CIR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3504
Country	:	US
Telephone Number	:	830-469-5190
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	MRS. MONICA ATHENA LARIOS
Credential	:
Telephone Number	:	830-469-5190

Provider Enumeration Date	:	01/26/2020
Last Update Date	:	01/26/2022

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Directions to “BEXAR COUNTY COMMUNITY SERVICES LLC ” Practice Location

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