Provider Demographics
NPI:1831968049
Name:SAN ANTONIO CENTER FOR HOPE AND HEALING
Entity type:Organization
Organization Name:SAN ANTONIO CENTER FOR HOPE AND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAT
Authorized Official - Middle Name:H
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPC
Authorized Official - Phone:210-602-7488
Mailing Address - Street 1:PO BOX 591848
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0142
Mailing Address - Country:US
Mailing Address - Phone:210-602-7488
Mailing Address - Fax:210-610-9848
Practice Address - Street 1:21720 HARDY OAK BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4835
Practice Address - Country:US
Practice Address - Phone:210-602-7488
Practice Address - Fax:210-610-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty