Provider Demographics
NPI:1043374267
Name:LUCIUS HODGE ALEXANDER JR
Entity Type:Organization
Organization Name:LUCIUS HODGE ALEXANDER JR
Other - Org Name:ALEXANDER RESIDENTIAL AND HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIUS
Authorized Official - Middle Name:HODGE
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-382-9798
Mailing Address - Street 1:16203 BRAESGATE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4850
Mailing Address - Country:US
Mailing Address - Phone:512-382-9798
Mailing Address - Fax:512-382-9798
Practice Address - Street 1:16203 BRAESGATE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4850
Practice Address - Country:US
Practice Address - Phone:512-382-9798
Practice Address - Fax:512-382-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities