Provider Demographics
NPI:1669802997
Name:HILL COUNTRY MHDD CENTER
Entity type:Organization
Organization Name:HILL COUNTRY MHDD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNEAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:830-792-3300
Mailing Address - Street 1:819 WATER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-792-3300
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:819 WATER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5333
Practice Address - Country:US
Practice Address - Phone:830-792-3300
Practice Address - Fax:830-792-5771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62054251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX62054OtherLPC LICENSE