Basic Information
| Provider Information | |||||||||
| NPI: | 1700258035 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIP- HEALTHY INNOVATIVE PROCESSES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 29735 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782290735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102713630 | ||||||||
| FaxNumber: | 2104442171 | ||||||||
| Practice Location | |||||||||
| Address1: | 5282 MEDICAL DR STE 605 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782296114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104477373 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2015 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | ROOSEVELT | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2102713630 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 56789 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251B00000X | N | Agencies | Case Management | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 261QM0850X | N | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.