Provider Demographics
NPI:1467669978
Name:LDS FAMILY SERVICES
Entity Type:Organization
Organization Name:LDS FAMILY SERVICES
Other - Org Name:LDS FAMILY SERVICES TX SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:210-541-1447
Mailing Address - Street 1:3201 CHERRY RIDGE ST
Mailing Address - Street 2:C-320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4823
Mailing Address - Country:US
Mailing Address - Phone:210-541-1447
Mailing Address - Fax:210-541-9995
Practice Address - Street 1:3201 CHERRY RIDGE ST
Practice Address - Street 2:C-320
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4823
Practice Address - Country:US
Practice Address - Phone:210-541-1447
Practice Address - Fax:210-541-9995
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LDS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX847444-2809251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health