Provider Demographics
NPI:1942290267
Name:TEXAS SAN MARCOS TREATMENT CENTER, LP
Entity Type:Organization
Organization Name:TEXAS SAN MARCOS TREATMENT CENTER, LP
Other - Org Name:SAN MARCOS TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SRVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:120 BERT BROWN ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5803
Mailing Address - Country:US
Mailing Address - Phone:512-396-8500
Mailing Address - Fax:512-754-3881
Practice Address - Street 1:120 BERT BROWN ST
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5803
Practice Address - Country:US
Practice Address - Phone:512-396-8500
Practice Address - Fax:512-754-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX827335323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR149375125Medicaid
IA0012310Medicaid
MS00220476Medicaid
AZ796089Medicaid
AKHS858PIMedicaid
PA0019433700001Medicaid
ND01560Medicaid
PA119451Medicaid
NV006388550Medicaid
NM09276327Medicaid
OK200032940AMedicaid
WY1228447-00Medicaid
MT4101692Medicaid
KY45002128Medicaid