Provider Demographics
NPI:1366450538
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity Type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:WACO CENTER FOR YOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-913-1580
Mailing Address - Street 1:701 W 51ST ST # MC-E619
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2312
Mailing Address - Country:US
Mailing Address - Phone:512-438-5618
Mailing Address - Fax:512-438-4220
Practice Address - Street 1:3501 N 19TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-2007
Practice Address - Country:US
Practice Address - Phone:254-745-5167
Practice Address - Fax:254-745-5367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1099665-02Medicaid
TX1404444-16Medicaid
TX00H27EMedicare PIN