Provider Demographics
NPI:1508596628
Name:AMERICAN GI FORUM NATIONAL VETERANS' OUTREACH PROGRAM
Entity Type:Organization
Organization Name:AMERICAN GI FORUM NATIONAL VETERANS' OUTREACH PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-248-9933
Mailing Address - Street 1:611 N FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1206
Mailing Address - Country:US
Mailing Address - Phone:210-223-4088
Mailing Address - Fax:
Practice Address - Street 1:206 SAN PEDRO AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1104
Practice Address - Country:US
Practice Address - Phone:210-248-9933
Practice Address - Fax:210-248-9986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty