The Extended Olive Branch Counseling Center LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in San Antonio, TX. Organization (NPI-2).
NPI number1619645975
StatusActive
Last updated in NPPESSep 14, 2021
Details
- NPI
- 1619645975
- Entity type
- Organization (NPI-2)
- Legal business name
- The Extended Olive Branch Counseling Center LLC
- Organization subpart
- No
- Enumeration date
- Sep 1, 2021
- Certification date
- Sep 14, 2021
- Last updated
- Sep 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 103TC1900X | Psychologist, Counseling | – | – |
Practice location
16320 Huebner Rd Ste 200San Antonio, TX 78248-1690
Phone 830-443-0553 · Fax 830-215-0223
Mailing address
16320 Huebner Rd Ste 200San Antonio, TX 78248-1690
Phone 830-443-0553
Authorized official
Joshua T Garcia
President
8304430553
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