Provider Demographics
NPI:1578685277
Name:RECOVERY BEHAVIORAL HEALTH OF SAN ANTONIO LLC
Entity Type:Organization
Organization Name:RECOVERY BEHAVIORAL HEALTH OF SAN ANTONIO LLC
Other - Org Name:THE DAPA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:GAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-783-8889
Mailing Address - Street 1:5500 GUHN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6161
Mailing Address - Country:US
Mailing Address - Phone:713-783-8889
Mailing Address - Fax:713-783-0499
Practice Address - Street 1:10515 GULFDALE ST
Practice Address - Street 2:SUITE 111
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3667
Practice Address - Country:US
Practice Address - Phone:210-227-3272
Practice Address - Fax:210-227-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)