Provider Demographics
NPI:1316158074
Name:MARK I RESIDENTIAL SERVICES INC.
Entity type:Organization
Organization Name:MARK I RESIDENTIAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-789-4079
Mailing Address - Street 1:1806 W STASSNEY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3677
Mailing Address - Country:US
Mailing Address - Phone:512-448-0965
Mailing Address - Fax:512-448-0966
Practice Address - Street 1:1806 W STASSNEY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3677
Practice Address - Country:US
Practice Address - Phone:512-448-0965
Practice Address - Fax:512-448-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities