Provider Demographics
NPI:1487309316
Name:THE ZILKER CENTER LLC
Entity type:Organization
Organization Name:THE ZILKER CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICAE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:KRASOVEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-660-6200
Mailing Address - Street 1:6009 GROVER AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-3421
Mailing Address - Country:US
Mailing Address - Phone:512-803-4160
Mailing Address - Fax:
Practice Address - Street 1:11905 MUSTANG CHASE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-6629
Practice Address - Country:US
Practice Address - Phone:512-660-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children