Provider Demographics
NPI:1679825491
Name:AUSTIN CHILDRENS SHELTER
Entity Type:Organization
Organization Name:AUSTIN CHILDRENS SHELTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEERIN
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:ABBAS HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:512-927-4717
Mailing Address - Street 1:10701 SORGHUM HILL CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 MANOR RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-5471
Practice Address - Country:US
Practice Address - Phone:512-927-4717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220041135251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management