Provider Demographics
NPI:1689980989
Name:SAN ANTONIO FIGHTING BACK INC.
Entity Type:Organization
Organization Name:SAN ANTONIO FIGHTING BACK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPPINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-271-7232
Mailing Address - Street 1:2803 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78203-2201
Mailing Address - Country:US
Mailing Address - Phone:210-271-7232
Mailing Address - Fax:210-271-1087
Practice Address - Street 1:2803 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78203-2201
Practice Address - Country:US
Practice Address - Phone:210-271-7232
Practice Address - Fax:210-271-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty