Provider Demographics
NPI:1093894859
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity Type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:SAN ANTONIO STATE SUPPORTED LIVING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE COMMISSINER
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 1:6711 S NEW BRAUNFELS AVE
Mailing Address - Street 2:STE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3004
Mailing Address - Country:US
Mailing Address - Phone:210-532-9610
Mailing Address - Fax:210-531-3877
Practice Address - Street 1:6711 S NEW BRAUNFELS AVE
Practice Address - Street 2:STE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3004
Practice Address - Country:US
Practice Address - Phone:210-532-9610
Practice Address - Fax:210-531-3877
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
TX207Q00000X, 207R00000X, 207W00000X, 2084N0400X, 2084P0800X, 315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000711401Medicaid
TX00QF73Medicare PIN
TXDD7941Medicare PIN