Provider Demographics
NPI:1407862170
Name:HEALTH AND HUMAN SERVICES COMMISSION
Entity Type:Organization
Organization Name:HEALTH AND HUMAN SERVICES COMMISSION
Other - Org Name:KERRVILLE STATE HOSPITAL
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 1:721 THOMPSON DRIVE
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5154
Practice Address - Country:US
Practice Address - Phone:830-896-2211
Practice Address - Fax:830-896-2373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH3002OtherBCBS DRUG/ALCOHOL
TX1273203-02Medicaid
TXHH4631OtherBCBH PSYCHIATRIC
TX1273203-03Medicaid
TX4540185OtherPHARMACY NCPDP NUMBER
TX1081028-01Medicaid
TX1081028-02Medicaid
TX454014Medicare PIN
TX1273203-02Medicaid