Provider Demographics
NPI:1043543762
Name:SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P.
Entity Type:Organization
Organization Name:SOLARA BEHAVIORAL HEALTH SAN ANTONIO, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER OF GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-914-1012
Mailing Address - Street 1:1975 BABCOCK RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4584
Mailing Address - Country:US
Mailing Address - Phone:210-340-0898
Mailing Address - Fax:210-340-0901
Practice Address - Street 1:1975 BABCOCK RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4584
Practice Address - Country:US
Practice Address - Phone:210-340-0898
Practice Address - Fax:210-340-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health