Provider Demographics
NPI:1902265002
Name:HILL COUNTRY COMMUNITY MHMR CENTER - YES WAIVER
Entity type:Organization
Organization Name:HILL COUNTRY COMMUNITY MHMR CENTER - YES WAIVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QM/UM
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-792-3300
Mailing Address - Street 1:819 WATER ST STE 300
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5330
Mailing Address - Country:US
Mailing Address - Phone:830-792-3300
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:819 WATER ST STE 300
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5330
Practice Address - Country:US
Practice Address - Phone:830-792-3300
Practice Address - Fax:830-792-5771
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILL COUNTRY COMMUNITY MHMR CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center