NPIMap

Organization Active NPI

Texas Adolescent Treatment Center

  • Community/Behavioral Health Agency
  • San Antonio, TX
National Provider Identifier
1356565360
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
17401 Issued in TX
Legal business name
TEXAS ADOLESCENT TREATMENT CENTER
Practice address
11845 West Ave
Apartment 1015
San Antonio, TX 78216-2554
Phone
(210) 772-9540
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Sergio Fernandez
Title
Director
Phone
(210) 568-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 17401 TX Primary
Mental Illness Community Based Residential Treatment Facility 320800000X 17401 TX

Addresses

Primary practice location

11845 West Ave
Apartment 1015
San Antonio, TX 78216-2554

Mailing address

8550 Huebner Rd
San Antonio, TX 78240-1803
Phone (210) 568-8550

Other identifiers 2

IdentifierTypeStateIssuer
147573301OtherTXCHIP
1475733MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Texas Adolescent Treatment Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1356565360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401803",
            "telephone_number": "210-568-8550",
            "fax_number": "210-568-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 WEST AVE",
            "address_2": "APARTMENT 1015",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162554",
            "telephone_number": "210-772-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS ADOLESCENT TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "210-568-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "17401",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "TX",
            "license": "17401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "147573301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1475733",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.