Provider Demographics
NPI:1013066893
Name:ST. PETER - ST. JOSEPH CHILDREN'S HOME
Entity Type:Organization
Organization Name:ST. PETER - ST. JOSEPH CHILDREN'S HOME
Other - Org Name:ST. PJ'S CHILDREN'S HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELING DIR, HIPAAPRIVACYOFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:210-531-8553
Mailing Address - Street 1:919 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-4501
Mailing Address - Country:US
Mailing Address - Phone:210-533-1203
Mailing Address - Fax:
Practice Address - Street 1:919 MISSION RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-4501
Practice Address - Country:US
Practice Address - Phone:210-533-1203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable