Provider Demographics
NPI:1699382663
Name:A-V SUPPORT SERVICES
Entity Type:Organization
Organization Name:A-V SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:210-837-7735
Mailing Address - Street 1:4302 FIRST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3634
Mailing Address - Country:US
Mailing Address - Phone:210-837-7735
Mailing Address - Fax:210-245-6697
Practice Address - Street 1:4302 FIRST VIEW DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3634
Practice Address - Country:US
Practice Address - Phone:210-837-7735
Practice Address - Fax:210-245-6697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2022-07-13
Deactivation Date:2022-06-10
Deactivation Code:
Reactivation Date:2022-07-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty