Provider Demographics
NPI:1275815813
Name:SANTACRUZ HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:SANTACRUZ HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLELIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTACRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:817-905-9618
Mailing Address - Street 1:901 BRIAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3868
Mailing Address - Country:US
Mailing Address - Phone:817-905-9618
Mailing Address - Fax:
Practice Address - Street 1:901 BRIAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3868
Practice Address - Country:US
Practice Address - Phone:817-905-9618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25988251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management