Provider Demographics
NPI:1932267325
Name:SOUTH TEXAS HABILITATION
Entity Type:Organization
Organization Name:SOUTH TEXAS HABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MED
Authorized Official - Phone:956-545-4649
Mailing Address - Street 1:334 AVENIDA DE LA PLATA
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2953
Mailing Address - Country:US
Mailing Address - Phone:956-545-4649
Mailing Address - Fax:
Practice Address - Street 1:334 AVENIDA DE LA PLATA
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2953
Practice Address - Country:US
Practice Address - Phone:956-545-4649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities