Provider Demographics
NPI:1669565529
Name:NUEVA VIDA BEHAVIORAL HEALTH ASSOCIATES,INC
Entity type:Organization
Organization Name:NUEVA VIDA BEHAVIORAL HEALTH ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZUFLACHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-616-0828
Mailing Address - Street 1:5555 FREDERICKSBURG RD
Mailing Address - Street 2:#102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3500
Mailing Address - Country:US
Mailing Address - Phone:210-616-0828
Mailing Address - Fax:210-616-0829
Practice Address - Street 1:9500 TIOGA DR STE A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3118
Practice Address - Country:US
Practice Address - Phone:210-616-0828
Practice Address - Fax:855-616-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17496101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty