Provider Demographics
NPI:1356745871
Name:EXCLUSIVE RESIDENTIAL CARE SERVICES INC.
Entity type:Organization
Organization Name:EXCLUSIVE RESIDENTIAL CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-399-8309
Mailing Address - Street 1:6323 SOVEREIGN ST
Mailing Address - Street 2:172
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5138
Mailing Address - Country:US
Mailing Address - Phone:210-399-8309
Mailing Address - Fax:
Practice Address - Street 1:6323 SOVEREIGN ST
Practice Address - Street 2:172
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5138
Practice Address - Country:US
Practice Address - Phone:210-399-8309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency