Provider Demographics
NPI:1760610406
Name:BE OF AMERICA - TEXAS SERVICES, LLC
Entity Type:Organization
Organization Name:BE OF AMERICA - TEXAS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:M. ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS-BILGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW
Authorized Official - Phone:512-216-7502
Mailing Address - Street 1:PO BOX 1694
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-1694
Mailing Address - Country:US
Mailing Address - Phone:512-216-7502
Mailing Address - Fax:512-847-0781
Practice Address - Street 1:700 RANCHO GRANDE DR
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5896
Practice Address - Country:US
Practice Address - Phone:512-216-7502
Practice Address - Fax:512-847-0781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities