Provider Demographics
NPI:1346333945
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity Type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:SAN ANGELO STATE SUPPORTED LIVING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE COMMISSIONER
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:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:TX
Mailing Address - Zip Code:76934-0038
Mailing Address - Country:US
Mailing Address - Phone:325-465-4391
Mailing Address - Fax:325-465-2878
Practice Address - Street 1:11640 US HIGHWAY 87 N
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:TX
Practice Address - Zip Code:76934-7000
Practice Address - Country:US
Practice Address - Phone:325-465-4391
Practice Address - Fax:325-465-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204D00000X, 207Q00000X, 207R00000X, 207W00000X, 2084P0800X, 315P00000X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual DisabilitiesGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000710801Medicaid
TX00QF72Medicare PIN
TX000710801Medicaid