Provider Demographics
NPI:1093306193
Name:SAGE RECOVERY & WELLNESS CENTER
Entity Type:Organization
Organization Name:SAGE RECOVERY & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ANSCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-306-1394
Mailing Address - Street 1:7201 GILBERT RD
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-5346
Mailing Address - Country:US
Mailing Address - Phone:512-306-1394
Mailing Address - Fax:
Practice Address - Street 1:7201 GILBERT RD
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-5346
Practice Address - Country:US
Practice Address - Phone:512-306-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAGE RECOVERY & WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility