Provider Demographics
| NPI: | 1730134586 |
|---|---|
| Name: | BEXAR COUNTY BOARD OF TRUSTEES FOR MENTAL HEALTH MENTAL RETARDATION |
| Entity type: | Organization |
| Organization Name: | BEXAR COUNTY BOARD OF TRUSTEES FOR MENTAL HEALTH MENTAL RETARDATION |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CREDENTIALING SPECIALIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JAZMYN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BIN-KALBAN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 210-261-1000 |
| Mailing Address - Street 1: | 6800 PARK TEN BLVD |
| Mailing Address - Street 2: | SUITE 200-S |
| Mailing Address - City: | SAN ANTONIO |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 78213-4200 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 210-261-1000 |
| Mailing Address - Fax: | 210-261-1821 |
| Practice Address - Street 1: | 6800 PARK TEN BLVD |
| Practice Address - Street 2: | SUITE 200-S |
| Practice Address - City: | SAN ANTONIO |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 78213-4200 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 210-261-1000 |
| Practice Address - Fax: | 210-261-1821 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-05-23 |
| Last Update Date: | 2025-11-05 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 137251802 | Medicaid | |
| TX | 214224201 | Medicaid | |
| TX | 137251806 | Medicaid | |
| TX | 137251805 | Medicaid | |
| TX | 214269701 | Medicaid | |
| TX | 214247301 | Medicaid | |
| TX | 214282001 | Medicaid | |
| TX | 214284601 | Medicaid | |
| TX | 137251803 | Medicaid | |
| TX | 137251807 | Medicaid | |
| TX | 137251808 | Medicaid | |
| TX | 137251806 | Medicaid |
