Provider Demographics
NPI:1689977928
Name:HAYS CALDWELL COUNCIL ON ALCOHOL AND DRUGS
Entity Type:Organization
Organization Name:HAYS CALDWELL COUNCIL ON ALCOHOL AND DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:K
Authorized Official - Last Name:COEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-396-7695
Mailing Address - Street 1:1901 DUTTON DRIVE STE E
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666
Mailing Address - Country:US
Mailing Address - Phone:512-396-7696
Mailing Address - Fax:512-396-7633
Practice Address - Street 1:1901 DUTTON DR
Practice Address - Street 2:STE E
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7573
Practice Address - Country:US
Practice Address - Phone:512-396-7695
Practice Address - Fax:512-396-7695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 64464101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty