| NPI | 1215007141 |
|---|---|
| Former Legal Business Name | PROVIDENCE SERVICE CORPORATION OF TEXAS |
| Entity Type | Organization |
| Authorized Contact | TINA WIER Billing Coordinator 512-343-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |