Provider Demographics
NPI:1164796330
Name:HILL COUUNTRY THERAPY SERVICES
Entity Type:Organization
Organization Name:HILL COUUNTRY THERAPY SERVICES
Other - Org Name:HILL COUNTRY THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINCAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-887-7095
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-0291
Mailing Address - Country:US
Mailing Address - Phone:210-887-7095
Mailing Address - Fax:
Practice Address - Street 1:522 SANDERLING
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-1798
Practice Address - Country:US
Practice Address - Phone:210-887-7095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101499251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health