Provider Demographics
NPI:1386812048
Name:HILL COUNTRY - SAN ANTONIO MANAGEMENT, INC.
Entity type:Organization
Organization Name:HILL COUNTRY - SAN ANTONIO MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:M. ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MLSW
Authorized Official - Phone:512-916-0600
Mailing Address - Street 1:PO BOX 1428
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-1428
Mailing Address - Country:US
Mailing Address - Phone:512-916-0600
Mailing Address - Fax:512-916-0607
Practice Address - Street 1:358 FM 1626
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748
Practice Address - Country:US
Practice Address - Phone:512-916-0600
Practice Address - Fax:512-916-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services