Provider Demographics
NPI:1821240060
Name:AUSTIN EATING DISORDERS PARTNERS, LLC
Entity Type:Organization
Organization Name:AUSTIN EATING DISORDERS PARTNERS, LLC
Other - Org Name:MCCALLUM PLACE AUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-732-2400
Mailing Address - Street 1:4613 BEE CAVES RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5212
Mailing Address - Country:US
Mailing Address - Phone:512-732-2400
Mailing Address - Fax:
Practice Address - Street 1:4613 BEE CAVES RD STE 104
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5212
Practice Address - Country:US
Practice Address - Phone:512-732-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital