Provider Demographics
NPI:1750603502
Name:RECREATIONAL THERAPY OF TEXAS LLC
Entity type:Organization
Organization Name:RECREATIONAL THERAPY OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-892-1841
Mailing Address - Street 1:PO BOX 592321
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259
Mailing Address - Country:US
Mailing Address - Phone:888-892-1841
Mailing Address - Fax:888-892-1839
Practice Address - Street 1:7601 GATEWAY BLVD
Practice Address - Street 2:# 224
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2671
Practice Address - Country:US
Practice Address - Phone:888-892-1841
Practice Address - Fax:888-892-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty