Provider Demographics
NPI:1760637250
Name:HILL COUNTRY SAN ANTONIO MANAGEMENT INC
Entity Type:Organization
Organization Name:HILL COUNTRY SAN ANTONIO MANAGEMENT INC
Other - Org Name:EAST TEXAS HILL COUNTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-340-8256
Mailing Address - Street 1:4142 MCKNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0844
Mailing Address - Country:US
Mailing Address - Phone:903-691-2514
Mailing Address - Fax:
Practice Address - Street 1:4142 MCKNIGHT RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0844
Practice Address - Country:US
Practice Address - Phone:903-691-2514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001008469OtherTEXAS DEPARTMENT OF AGING AND DISABILITY