Provider Demographics
NPI:1225191711
Name:SOUTH TEXAS COMMUNITY LIVING CORPORATION
Entity Type:Organization
Organization Name:SOUTH TEXAS COMMUNITY LIVING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-1758
Mailing Address - Street 1:18 AUGUSTA PINES DR STE 140E
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4013
Mailing Address - Country:US
Mailing Address - Phone:281-351-1758
Mailing Address - Fax:281-255-4500
Practice Address - Street 1:18 AUGUSTA PINES DR STE 140E
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-4013
Practice Address - Country:US
Practice Address - Phone:281-351-1758
Practice Address - Fax:281-255-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117447320900000X
TX117599320900000X
TX116253320900000X
TX116673320900000X
TX115609320900000X
TX115163320900000X
TX117600320900000X
TX115610320900000X
TX115478320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities