Awakenings Hill Country LLC

Key facts

NPI: 1003689936
Entity type: Organization (NPI type 2)
Primary specialty: Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name: AWAKENINGS HILL COUNTRY LLC
Practice address: 204 Jefferson
Kerrville, TX 78028
Phone: (830) 302-2922
Fax: (830) 326-6660
NPI assigned: Nov 2, 2023
Organization subpart: Yes
Parent organization (as reported): AWAKENINGS HILL COUNTRY LLC

Authorized official

Name: Jose A Miranda
Title: Director of Ur
Phone: (210) 485-8065

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Awakenings Hill Country LLC Substance Abuse Rehabilitation Facility · Fredericksburg, TX · NPI 1073999678

NPPES parent name

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Awakenings Hill Country LLC Substance Abuse Rehabilitation Facility · Fredericksburg, TX · NPI 1073999678

NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

James Carroll Boone, MD Addiction Medicine (Preventive Medicine) Physician · Hunt, TX · NPI 1043396211

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
45D2300205	The Fullbrook Center - Iop 204 Jefferson St, Kerrville, TX 78028	Certificate of waiver	Mar 4, 2028

National Provider Directory

Tax ID family: Awakenings Hill Country LLC (2 organizations share this tax ID)
Part of: Awakenings Hill Country LLC

Locations

184 Fullbrook Ln
Fredericksburg, TX 78624
Phone (806) 669-7976

204 Jefferson St
Kerrville, TX 78028
Phone (830) 302-2922

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Mental Health Clinic/Center	261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X			Yes

Addresses

Primary practice location

204 Jefferson
Kerrville, TX 78028

Mailing address

184 Fullbrook LN
Fredericksburg, TX 78624-8313
Phone (830) 302-2922

Other names

The Fullbrook Center Doing business as

Other providers in Kerrville, TX

Kenneth Bruce Aspinall, PH.D.
Aspirations Psychological Services PLLC
Atalee Recovery Center Inc.
Audiology and Hearing Services of Kerrville PLLC
Kayla Avirett Zachry, OD
Lari Aycock, LCSW
Rhonda M Bacilieri
Miriam Backhoff
Johni Jean Badder, R.N
Jodie Lyn Baker, APN

All providers in Kerrville, TX · Substance Use Disorder Rehabilitation Clinic/Center in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.