Provider Demographics
NPI:1073692604
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity Type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:CASTLE RIVER GROUP HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALCHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-438-3076
Mailing Address - Street 1:PO BOX 9297
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78469-9297
Mailing Address - Country:US
Mailing Address - Phone:361-888-5301
Mailing Address - Fax:361-844-7910
Practice Address - Street 1:4013 CASTLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-3634
Practice Address - Country:US
Practice Address - Phone:361-888-5301
Practice Address - Fax:361-844-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001000830Medicaid