Provider Demographics
NPI:1457784605
Name:AUSTIN CONNECT TO WELLNESS, LLC
Entity Type:Organization
Organization Name:AUSTIN CONNECT TO WELLNESS, LLC
Other - Org Name:ABA CONNECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PLACHTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-898-9044
Mailing Address - Street 1:PO BOX 151716
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78715-1716
Mailing Address - Country:US
Mailing Address - Phone:512-898-9044
Mailing Address - Fax:512-857-1423
Practice Address - Street 1:4407 PACK SADDLE PASS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1623
Practice Address - Country:US
Practice Address - Phone:512-898-9044
Practice Address - Fax:512-857-1423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041740103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty