MEDICARE: HILL COUNTRY SUPPORT 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
1	251C00000X	Developmentally Disabled Services Day Training Agency		TX

General Provider Information

NPI Number	:	1982649687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL COUNTRY SUPPORT SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1428
Second Line	:
City	:	MANCHACA
State	:	TX
Zip	:	78652-1428
Country	:	US
Telephone Number	:	512-916-0600
Fax Number	:	512-916-0607

Provider Business Practice Location Address
First Line	:	358 E FM 1626
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-3909
Country	:	US
Telephone Number	:	512-916-0600
Fax Number	:	512-916-0607

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CHERYL KING STANDIFER
Credential	:	B.S.
Telephone Number	:	512-773-7047

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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