Provider Demographics
NPI:1093341521
Name:UPEKKHA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:UPEKKHA BEHAVIORAL HEALTH LLC
Other - Org Name:UPEKKHA BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA, LCSW
Authorized Official - Phone:210-325-7156
Mailing Address - Street 1:8430 TIMBER CREST ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-4405
Mailing Address - Country:US
Mailing Address - Phone:210-325-7156
Mailing Address - Fax:
Practice Address - Street 1:5503 GRISSOM RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-3036
Practice Address - Country:US
Practice Address - Phone:210-325-7156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty