Provider Demographics
NPI:1619394913
Name:SJRC TEXAS, INC.
Entity Type:Organization
Organization Name:SJRC TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLYE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-876-6763
Mailing Address - Street 1:1400 RIDGE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-2804
Mailing Address - Country:US
Mailing Address - Phone:210-876-6763
Mailing Address - Fax:830-885-4354
Practice Address - Street 1:1400 RIDGE CREEK LN
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2804
Practice Address - Country:US
Practice Address - Phone:210-364-3972
Practice Address - Fax:830-885-4354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty