Provider Demographics
NPI:1376185298
Name:ELDER CARE BEHAVIORAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:ELDER CARE BEHAVIORAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STRAIGHT LINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-395-4520
Mailing Address - Street 1:10410 DOHERTY SPG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-1041
Mailing Address - Country:US
Mailing Address - Phone:210-395-4520
Mailing Address - Fax:210-395-4521
Practice Address - Street 1:10410 DOHERTY SPG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-1041
Practice Address - Country:US
Practice Address - Phone:210-395-4520
Practice Address - Fax:210-395-4521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty